HomeMy WebLinkAboutMortgage_Bertram STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ounty Township Year
.- ,,•=• FOR DEDUCTION FROM ASSESSED VALUATION /��J
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.if ' fv Slate Form 43709(R13/10-15) - ( a 3 v `1(ty �
,;,a < Prescribed by Department of Lo ovemmeat Finance 6\1\0.4.r�1NSTRUCT/ONS: File;lred
To be filed in person or by mail with:
Filing Dates: 1) Real Property:Must be completed and date 1 in the cale d r ear for which the deduction is sought.
Must be filed or postmarked with the County Auditor or my 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)
John Michael Lee Bertram
Taxing District Key number/legal description kartocl nya Y yag ltl bJohnson 26-19-36-300-002.502-024 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?
$270,800.00 I?' 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
IZI Real Property ❑ Annually Assessed
• Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union' J ? �f
Address of mortgagee or contract seller(number and street,city,state,and ZiP code) t ' 'L `
4401 Theater Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage DEC 16 2020
Address of assignee(number and street,city,stale,and ZIP code)
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Does applicant own property in any If yes,what county? What Taxing District? Has this r , 1 �4 tf,,,ps,=stat mount of deduction
other county on propUt9 � M I°A
in Indiana? Dyes E No current year? 11;Yes No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or ,'tract 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 t t 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 ,, County \ mon h,riyyemN - SO Ite. rlc
I l We certify under the pena,o ierjury that the a e and foregoing information is and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Si na re(owner's full name) Date(month,day,year)
,� 09/16/2020
Fu resident address of applicant(number and street,city,slate,and ZIP code)
4926 E 1050 S, Haubstadt, IN 47639
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)