HomeMy WebLinkAboutMortgage_Smith (11) .0,8-, a. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4;K PhD FOR DEDUCTION FROM ASSESSED VALUATION
- i,:/i- Gibson 0211 . 2020
„x".,T t State Form 43709(R14/1-20)
'die Prescribed by Department of Local Go ent Finance Ilia u i+"D
�(` File Mark
INSTRUCTIONS: To be filed in person or by mail. w�� DEC 3 0 2020 Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. Ir 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. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Mark Smith and Tara Smith
Taxing District Key number/legal description Record number P us
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Hau dt 3D�If �mbf-+26-23-16-400-001.924-024/COUNTRY AYRE EST 4 D-9 ) , Q� 1�v
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 $244,000.00 'Yes 0 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
ra --I Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract sellerLE 111:4;
Diamond ValleyFederal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
840 Diamond Avenue, Evansville, IN 47711 ®zc a 1 2Q2®
Name of assignee or other owner or holder of mortgage
r -----
Address of assignee(number and street,city,state,and ZIP code) %, . •_ '
Does applicant own property in ny ' If yes,what county? What Taxing District? G%IB501n-as is deduct' ben requested If yes,state amount of deduction
other county on property for Yes El NO
in Indiana? El Yes El0 current year?
A person is not entitled t t eduction unless the person has a balance on the person's mortgage or contr 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 20
Signature of County Auditor `, County Date_( n�(r,ly_year)
41 Gibson I --O
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resi ent ondiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sig re(owner's full name) A Date( nth, �y,ye
rd al
Full resident address of applicant(number and street,city,state,and ZIP code)
2202 E.Warrenton Rd., Haubstadt, IN 47639
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 fnr nerirm,can include imprisonment uo to two and a half years and a fine not to exceed$90,000.
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