HomeMy WebLinkAboutMortgage_Miller (25) 49..1_144,,„, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
t�`"'- `34 \o FOR DEDUCTION FROM ASSESSED VALUATION
(401 " S = State Form 43709(R14/1 20) 0 2 2020
\t .'_�:4- Prescribed by Department of Local Government Finance File Mark
rare
INSTRUCTIONS: _
To be filled in person or by mail. For led with:
Filing Dates: Form must be completed and dated in the calendar year for which the deduction is sought.
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 ae first due County Auditor
and payable. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Joshua J. Miller and Emily S. Miller
faxing Distr Key number/legal description 26-11-31-300-004.241.021 /6161 W. Re r�nu b, Page number
1 Stalheim Ave., Owensville, Indiana 47665 A9
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of 1 Is th applicant the sole
assessment date,current year assessment date,current year date of application legs r equitable owner?
$277,406.00 ; Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with who
If name on record is different than that of applicant,indicate below: s e property in question: Annually Assessed
`(r`: Real Property ID Annually Assessed
_ >. , ), Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller /(,,3
Evansville Teachers Federal Credit Union N
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) aJ' Q�
4401 Theater Drive, Evansville, IN 47715 ��• &C6 \ o`•,,O
Name of assignee or other owner or holder of mortgage `� PJ
Address of assignee(number and street,city,state,and ZIP code) ` J�
Does applicant own property in any If yes,what county? What Taxing District? Has this dedu' .n been requested If yes,state amount of
other county on property4." deduction
iin Indiana? 0 Yes 0 No current yrca?? 0 Yes 0 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 20 20 20 20 20
Sign ure of County Auditor County Date(month,day,year)
I/We certify under the enalty of perjuryJig)
a above and foregoing information is true and correct and that the applicant is a resident of Indiana
2rx\_0_44_
and owner/contract buyer of the aforemtioned property on date application is filed.
SKiatur (ownifuIr1/21,61 � Date o year)
F esiden as of a lira t(number and street,city,state,an 1 code " 1 � � n/ I/ltgn
P )
6161 W Stalheim Ave., Owensville, IN 47665
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 imprisonment up to two and a half years and a fine not to exceed$10,000.