HomeMy WebLinkAboutMortgage_Pheral (2) 4 4- Qa. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS et;1 ty, Thwnship Year
t' 3 ,.o FOR DEDUCTION FROM ASSESSED VALUATION biti) ((�J..�t,Jl 2020
Sk ,'r ,, ,? State Form 43709(R13/10-15)
`' File Mark
,iv %- •' Prescribed by Department of Local Government Finance
MI6
INSTRUCTIONS:
To be filled in person or by mail. Form file 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)
Lucas R. Pherallaand Jaleigh C. Bugher-Pheral
Taxin istrict� Key number/legal description 26-12-18-103-004.384
Ave., Princeton, Indiana 47670 028/408 W. Garfield Record number Page number
�{� �2 0 .�,,2 (� '7
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
$169,814.00 ❑Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the property in question: Annually Assessed
❑ Real Property ❑Annuall Assessed
v To •I e(IC 6-1.1-7)
Name of mortgagee or contract seller I' II � ''
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) N O V 3 2�2�
4401 Theater Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) 66
GIBSON COUNTY AUrITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of
other county on property for deduction
in Indiana? ❑ Yes 0 No current year? 0 Yes ❑ No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity line 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
Signat o ountyAud' r County Date(mont day, ar)
Tu, A_Se ) h1 /3/2O22
/W certify under penalty of perjury tthe abov and foregoing information is true and correct and that the app scant is a resident of Indiana and
Sc)o r contract buyer of the aforementioned property on date application is filed.
natu owner' i`ull name) / 4.,,t,A._ Dir Toph,fay ye r)
Full resident address of applicant(number and street,city,state,and ZIP de)
408 W Garfield Ave., Princeton, IN 47670
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.