HomeMy WebLinkAboutMortgage_Conner (7) 144, , ` STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Co my Township Year
" 3- 1- FOR DEDUCTION FROM ASSESSED VALUATION '' •
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3t , ; y _, State Form 43709(R13/10-15) 'I /SDn 2020
.k.i .. .-' '' • Prescribed by Department of Local Government Finance File Mark
tam
INSTRUCTIONS:
To be filled in person or by mail. Form filed ith:
Filing Dates:1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the
property is located on or before January 5 of the immediately succeeding calendar year. County Auditor
2)Mobile/Manufactured Homes not assessed as Real Property: Must file with the County Auditor of the ❑ County Recorder
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Brian C.Conner and Jessica L. Conner
y Taxing Districtiliw, Key number/legal description 26-19-21-200-002.152-025/2371 E 750 S, Recordn number Page number
Fort Branch, Indiana 47648 0cit cO ,5 (a
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the ap cant the sole
assessment date,current year assessment date,current year date of application legal o equitable owner?
$169,000.00 Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spou ,indicate with w
If name on record is different than that of applicant,indicate below: Is the roperty in question: Annually Assessed
eal Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union FIL, i ;a 7}
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theater Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage N O V 1 3 2020
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any If yes,what county? What Taxing District? Has thimpopoNr t heed D ITO FT yes,state amount of
other county on property far deduction
in Indiana? 0 Yes 0 No current year? Yes 0 No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or co tract indebtedness that is recorded in the county
recorder's office(including any home equity fine of credit that is recorded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signetaf2 f County dit County // Date(month, ay,year)
�� O Sph� lyp..3/Z D 2U
/ certify under penalty of p 'u r that the above and egoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sig Lure(owner's full name) DTI yolh_:lay,
year)AV 6-
Full resident address of applicant(number and street,city,state,a d ZIP code)
2371 E 750 S, Fort Branch, IN 47648
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person(number and street,city,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.