HomeMy WebLinkAboutMortgage_Mosby (2) �7-A STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
;`'sit FOR DEDUCTION FROM ASSESSED VALUATION
t,al Gibson 132.. i 2020
,; `: State Form 43709(R14/1-20) g F CE:,'VEf
'tale-- Prescribed by Department of Local Government Finance ''
2020 File Mark
INSTRUCTIONS: To be filed in person or by mail. e •
1 DECG
IF-o�rrm filed with:
Ir
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. I County Auditor
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 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) •
B.Todd Mosby and Kimberly S. Mosby
Taxing District Of"�Zli j. Key number/legal description Record number Page number
-John�soon I 26-23-15-400-001.709-024/PT SE 15 4 10 2.30 AC D-9 �,'O S1 q 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?
$0.00 $344,700.00 tE 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
u Real Property 0 Annually Assessed
MoNo I I®ntr AINf100 NOS81bile Home(IC 6 1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theater Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage OZOZ 3 I J 3 Q
Address of assignee(number and street,city,state,and ZIP code) • ri f--7 F`
Does applicant own property in any If yes,what county? What Taxing District? ' Has this deduction been q ested- state amount of deduction
other county on property for in Indiana? El Er No current year? El Q 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 0 20 20 20 20
Signature of County Au 't County Date nt, ark
rn1 1 Gibson 12 to
I/We certify under enalty of perjury thøandfor oing information is true and correct and that the applicant is a resident f Indiana and
o er/contract buyer of the aforem tinned grope on d to applicati n is filed.
ig ature(owner's name) Date(month,day year'
• DE 0 9 2026
II r id�PSCaddress of applicant(number anc(street,ci state,and ZIP code)
12739 S.350 E., Haubstadt, IN 47639„
Person authorized by duly executed Power of Attorney o C 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person(number and street,city,state,and ZIP code)