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HomeMy WebLinkAboutMortgage_Montgomery (15) 4-'R- , STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ounty Township Year Cr_•^°% FOR DEDUCTION FROM ASSESSED VALUATION ;`;.!.• StateForm43700(R14/1-20) .3 OVA ©� l w • �'✓' Prescribed by Department of Local Government Finance �.J 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. P;( 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 faxes 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) Kimberly Montgom ry and Carl N. Ball Jr_ & Cheryl Ball, h sband & wife Taxing District Key number i legal description Record number Page number Daq �ata-I1"-(3t/-360 -co11rl-0p cool 0052/ -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? $21 5 1 Oft $tao, 0hlo $1 ao, p0f EYes El No If no,what is his I 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 ques 4•• *• uaily Assessed ® rop= y ■11:1) =eIlyAssHome(Ielset C 6-1.1-7) Name of mortgagee or contract seller Evansville.. Teachers FedPt41 Credit io- iO21 Address of mortgagee or contract seller(number and street,city,stae,end ZIP code) . .0 .5 4401 Theater Drive, Evansville, IN 47715 Name of assignee or other owner or holder of mortgage , � 1 oa TY-AuD Address of assignee(number and street,city,state,and ZIP code) G1BSCN CO Does applicant own property In a If yes,what county? What Taxing District? Has this deduc on b n requested If yes,state amount of deduction on propertyfor in Indiana?ty ❑Yes No currnt yer? Yes ❑No A person is not entitled to this deduction unless the person has a balance on the person's mortgage or con ract 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 Audito�� Cou Date(month,day,year) LnA, 0 - `% b. I - -f 0 - I/W�certify under the penalty of perjury that the ab a and going information is true and correct and that scant is a resident of Indiana and owner/contract buyer of the aforementioned property on date application is filed. .gn� a(owner's full name) � // `Date(m fh,de*year) 1 ,,,i/� f�'1j1�2 � / o2qdo co u resident adgtess of applicant(n ber rJ73 sire c y,state,and Zlfscode il 143tto Lo 0 keel r ©i[OW 1A�i aai l-r -� 4/7/�3‘ , Person authorized by duly executed Power of Attorney or by IC 8.1.1-12-0.7 Date(month,day,year) Address of authorized person (number and street,city,state,end ZIP code) The nennit/es for ceriury can Include imprisonment up to two and a half years and a fine not to exceed$10,000.