HomeMy WebLinkAboutMortgage_O'Connor � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
.}'^ County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION I` /y�
s�y�_1`-'-• State Form 43709(R13/10-15) S 0 r) t t 2� A M
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i° Prescribed by Department of Local G nment Fin ce v �J
INSTRUCTIONS: File Mark
To be filed in person or by mail. F rm ded with:
Filing Dates: 1) Real Property:Must be completed an ated in t calend year fo w ich the dedu tion is sought.
Must be filed or postmarked with the County Audi or or County Reco er of the cou 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)
Michael A. O'Connor and Ashley A. O'Connor, husband and wife
Taxing District Key number/legal description Record n ber Page r,�
Patoka Q, 26-12-03-400-001.927-02-4' JJ<< �t _
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid�s the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
$123,200.00 0 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
: operty 0 Annually Assessed
Fi _.&_,,
Name of mortgagee or contract seller k
0 Mobile Home(IC 6-1.1-7)
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) DEC 16 2020
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) °
GIBSON COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction a equested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes 0 No current year? es ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or n ct 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 offic the is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditorlc\ County Date(moot ,day ye r).� `
I I We certifyunder the a of perjury that the a ove and foregoing information ire and correct and.that the applicant is reside t of Indiana and
P Prjry
owner/contract buyer of the aforementioned property on date application is filed.�
Sign tur w ersl name) �� �(� Date(month,day,year)
19, / 4��\T 08/20/2020
Fullresident a ress of applicant(number and street,city,state,and ZIP code)
3316 E 50 N, 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 imprisonmen p to two and a half vearc and a fine not to exceed$10,000.