HomeMy WebLinkAboutMortgage_Sands l � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
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State Form 43709 R13/`� Prescribed byDepartme Local Government Finance
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INSTRUCTIONS: l^�—p� rivoi\ I IFile Mark
To be filed in person or by mail. Q1�1,1 Form filed with:
Filing Dates: 1) Real Property:Must be completed aated in the alendar y for which the deduction is sought.
Must be filed or postmarked with the County Audito or County Recorder of the county where the property is County Auditor
located on or before January 5 of the immediately succeeding calendar year. County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the 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)
Jacob J Sands and Amanda M. Sands, husband and wife
Taxing District Key number/legal description Record number Page nu b
mok
Ft. Branch 26-19-18-101-001.159-026 `� . y } ..
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?
$208,000.00 p Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union F I I)
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theater Drive, Evansville, IN 47715 DEC 2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) /�
t� cQ� )lppl`L�`I y i �p�t� t (�
Does applicant own property in any If yes,what county? What Taxing District? Hdslgi5ili8 it,. teeuatYPI-1f9er$state amount of deduction
other county on property for
in Indiana? Yes No current year? ��
❑ ❑ Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage o con ract 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
Signature of County Auditor .i.\ County Date(Mon(,day,year)
mso
r9sc
01)
30/1
I/We certify under the penalty of perjury t ov nd foregoing information is t and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforeme tioned property on date application is filed.
Signature(owners II n mef f �� Date(month,day,year)
t ,A_,-.4— _ t!1, ..lc�g e'1 10/15/2020
resident a re of applicant(number and street,city,state,and ZIP code)
11 Blae foot Drive, 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)
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