HomeMy WebLinkAboutMortgage_Doane <97, � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
- " ,i.:1 i Gibson 0 2020
%- '' State Form 43709(R14/1-20) RECEIVED
��``'�' RECEIVED G Ft
one Prescribed by Department of Local Government Finance
NOV 1 4p''` File Mark
INSTRUCTIONS: To be filed in person or by mail. O.rg
C )V Form filed with:
El Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. 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)
Jason K. Doane
Taxing District Key number/legal description Record number Pa nu ber
Princeton 26-12-07-204-002.544-028/ NS LOT 1 PT R3 daps/
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 $161,000.00 E 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
i -,Q,Re .-• 0 Annually Assessed
1 s ilk
Mobile Home(IC 6 1.1-7)
Name of mortgagee or contract seller - —_ -x
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) • N O V 2 4 2020
4401 Theater Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) GIBSON COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county on property for in Indiana? Yes Q No current year? Elr7t No Yes LI
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
I
Signature of County Auditor County Date(month,day,year)
Gib
I/We certify under penalty of perjury t the above and foregoing inform on is true a correct and that the a D ...,,, _ Iicant is a resident of Indiana and
owner/contract buyer of the of r eenntioned property on date applicatio is filed.
Si nature(o II nam FT, Date mont d
F II resident dress of applicant(number and street,city,state,and ZIP code)
20
2002 E. Broadway St., Princeton, IN 47670 JAN 05 204.E
- 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) l.�„ ' __S a Z/ki�6j
IDSON COUNTY AUDITOR
The penalties for oeriury can include imprisonment Uri to two and a half years an a tine not to exceed, 10.000.