HomeMy WebLinkAboutMortgage_Pertenheimer •
:E, fz,�. STATEMENT OF MORT_GAGE_QR_C_ONTRAC_T_INDEBTEDNESS County Township Year
-�•% 4� FOR DEDUCTION FR - .70
'i '' i'` '/ / Gibson Princeton 2020
f. State Form 43709(R14/1-20)
''" --J Prescribed by Department of L 'y/ LL46-0-2,ale / 14 h�1,-7,6.--,- File Mark
INSTRUCTIONS: To be filed in person or b /� q�S al/iv q�.4i G-R ?-S Form filed with:
Filing Date: Form must be completed an L t.
Must be filed or postmarked C Q��i, ere the property is l� County Auditor
located on or before January / :re and payable. ❑ County Recorder
See reverse side for additional instructions ar,u yuo,,,,.au.,,.,.
Applicant(owner or contract buyer-see restrictions on reverse side)
Philip & Cynthia Partenheimer
Taxing District Key number/legal description Record number Page number
Princeton 26-12-07-303-002.084-028 Qo 70 Lir›oe
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?
$ 60,000 ZYes ❑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
Real Property ❑Annually Assessed
ft
r Mobile Home(IC 6 1.1 7)
Name of mortgagee or contract seller • s _
a
Evansville Teachers Federal Credit Union r�
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 404n q p ,se t.J
Name of assignee or other owner or holder of mortgage ( 6® (/
'90 A . ‘
Address of assignee(number and street,city,state,and ZIP code) C��/
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been rdltkfM If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes ®No current year? ®Yes ❑ oOf
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
Signature of County Auditor County Date(month,day,year)
Au 1./1 Gibson 12/28/2020
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
. -'wne /contract buyer of the aforementioned property on date application is filed.
i n =(o ner'�,tyll n e) Date(month,day,year)
t� `/ 12/28/2020
Full resident a.dress of applicant(number and street,city,state,and ZIP code)
630 S Hall St., Princeton, IN 47670
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,yeah
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.