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HomeMy WebLinkAboutMortgage_Johnson 4ETe STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year .,c1 .a FOR DEDUCTION FROM ASSESSED VALUATION a ,:=,:2 1 State Form 43709(R14/1-20) Gibson Patoka Township 2020 ...or_s« Prescribed by Department of Local Government Finance File Mark INSTRUCTIONS: To be filed in person or by mail. Form filed with: Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. 171 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) Jeffery C & Cathy M Johnson Taxing District Key number/legal description Rec rd number Pa num Patoka Township 26-11-01-100-004.661-027 Jo,w 0 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? $45,000 llYes ❑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 th roperty in question:Annually Assessed ®ja P.[;operty ❑Annually Assessed �� Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller 4 Evansville Teachers Federal Credit Union ''1 4/2) Address of mortgagee or contract seller(number and street,city,state,and ZIP code) ©F C2 0 Name of assignee or other owner or holder of mortgage %so���� �020 Address of assignee(number and street,city,state,and ZIP code) CD Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested ",9yps,state amount of deduction other county on property for C/T in Indiana? ❑yes ®No current year? ®Yes ❑No • Q,c;, 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 r' CAi7-y 111 Signature of County Auditor County �AJ5V la• 1 t I/We certify under the penalty of perjury that the above and foregoing information is true a • � 7 `,�6v Al.�/n owner/contract buyer of the aforementioned property on date application is filed. r O1 /`}� (� w Sig ur wner's full name) c / / /z . Zgi —Z6 2,0 /1c 'ides ddress of a.iicant(number and street,city,state,and ZIP code) 1203 W 150 N, 'rinceton, 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) Trenalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.