HomeMy WebLinkAboutMortgage_Krieg (2) R��a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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w.._ <z FOR DEDUCTION FROM ASSESSED VALUATION Q l ^�
glY ?•','-.i. State Form 43709(R14/1-20) Gibson L w
�"...4, Prescribed by Department of Local Government Fi ce
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File Mark
INSTRUCTIONS: To be filed in person or by mail.
Form filed with:
Filing Date: Form must be completed and dated in the calendar year f which the duction is ght. m County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the cou where the property is
located on or before January 5 of the calendar year in which the property taxes are first due and payable. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Tracy J. Krieg
Taxing District Key number/legal description M PSUbo/J�
Center 26-13-19-400-001.794-004 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?
$136,200.00 ®Yes ❑No
If no,what is his I 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 t 1 question:Annually Assessed
CEO - PS. 0 Annually Assessed
F
i . Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
First Federal Savings Bank of Evansville
Address of mortgagee or contract seller(number and street.city,state,and ZIP code) ' DEC 1.C 2020
5001 Davis Lant Dr., P.O. Box 1111, Evansville, IN 47706 • ---
Name of assignee or other owner or holder of mortgage `040`
Address of assignee(number and street,city,state,and ZIP code) t.IBSON COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deductio en requested If yes,state amount of deduction
other county on property for
in Indiana? ['Yes l No current year? Yes ❑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 office that is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 I 20
Signature of County Auditor Counk / Oat ( h, y,year)
'T(\i-NV\
I/We certify under the penalty of perjury thCT
bove and foregoing informal'on s true and correct and that the applicant is resit ent of Indiana and
owner/contract buyer of the aforementioned property on date application is file .
Signat re ir's full name) Date(month,day,year)
/ 11/18/2020
Full resident address of pr nt(n14(
er and street,city,state,and ZIP code)
2469 S 650 E, Francisco, IN 47649
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)