HomeMy WebLinkAboutMortgage_Ortiz Otwr"N. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
1-4: 4 FOR DEDUCTION FROM ASSESSED VALUATION
„'` . `„ State Form 43709(R14/1-20) Gibson OIS
�� RECEIVED
t"aro�-�' Prescribed by Department of Local Gov ment Finance
• File Mark
INSTRUCTIONS: To be filed in person or by mail. C MN,I DEC 212020 Form filed with:
Filing Date: Form must be completed and dated in the cal ndar year fo which t eduction is sought. VI County Auditor
Must be filed or postmarked with the County Auditor or County Reco r 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)
Ernesto Ortiz and Rosa Ortiz, husband and wife
Taxing District Key number!legal description Rgeord number P�e nu�tr,
Princeton 26-12-08-203-002.806-028 —`)(V,r11/^V (Cj 7--a
Assessed value of real property as of Mortgage I 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?
$70,000.00 11Yes ❑No
If no,what is his 1 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
e I Pipe �'AI uai Assessed
I _ r Mobile;ome(IC 6-1.1-7)
Name of mortgagee or contract seller �" y
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) DEC 21 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) GIBSO COUtIlY <-:v i OR
Does applicant own property in any If yes,what county? What Taxing District? Has this deducti en requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes VI No current year? Yes 0 No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or n act 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 vc 20 20 20 f 20 20 20
Signature of County A .r• County \ eloe\ Date( nth,day,year)
I,We certify under the pen Ity of pe' above and foregoing information is Xruetiand correct and that the applicant is a resident of Indiana and
owner/contrac yer of a aforemention roperty on date application is filed. �J
n r (ow r' ull a ) / Date(month,day,year)
� aa yl , �� 12/15/2020
ul reside addre sofa pl. nt(number nd street, , nd ZIP code)
1905 E Taylor Ave., Prin ton, 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 nenaltiAc for',orlon/ran inrhrde imnrisnnmenf un to two and a half vearc anti a fine not to errand.Rln nnn