HomeMy WebLinkAboutMortgage_Jones (11) gig`="ems STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
--- 5 FOR DEDUCTION FROM ASSESSED VALUATION
-, Gibson oOq 2020= f State Form 43709(R14/1-20) RECEIVED
and`.? Prescribed by Department of Local Gov
DEC 3 ,O 20�0 File Mark ment Finance
('�cc
INSTRUCTIONS: To be filed in person or by mail. � � I Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. RI 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)
Ryan W.Jones
Taxing District Key number/legal description Record nu er Pag��J\(((e n ler'
Haubstadt 26-23-06-101-000.668-009/SUNRISE ACRES 2 6
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 o equitable owner?
$0.00 $152,000.00 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: s t e property in question:Annually Assessed
roperty 0 Annually Assessed
I I
Name of mortgagee or contract seller
Fi Mobile Home(IC 6 1.1-7)
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) DEC 3 .& MO
4401 Theater Drive, Evansville, IN 47715 _
Name of assignee or other owner or holder of mortgage Ir l
We to
Address of assignee(number and street,city,state,and ZIP code) GIBSOFd COU 9 Y lAdDITOR
Does applicant own property i any If yes,what county? What Taxing District? Has this deductia en requested If yes,state amount of deduction
other county ❑Yes NO on property for Yes ❑ NO
in Indiana? current year?
A person is not entitled o tt`deduction unless the person has a balance on the person's mortgage or on 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 7County Date(month day ear)
*WA Gibson l -3�` 020
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
S' turd(o is fu�,game) A - Date , nt ,�dpy,��ar) alp
�IY/ �/WYCI M Its— /11v�—?
Full reside dress of applicant(numbe nd street,city,state,and ZIP code)
409 S. adley Dr., Haubstadt, N 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)
n,,,.,n.,.,IFin..s ;.,nI.,,a.,;.,,n.,e•,,.,.,,,,s,,.,♦,.ti.ION,,.,,v h&f l.,,n.-.,n.F n fines nnf Fe,nvnoo,!re1n rirlrl