HomeMy WebLinkAboutMortgage_Short ,0:TN.
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
:_ 1FOR DEDUCTION FROM ASSESSED VALUATION Gibson 0 oy 2020
:. �' State Form 43709(R14/1-20)
aa!3 Prescribed by Department of Local Government Finance RECEIVED
�e�s
File Mark
INSTRUCTIONS: To be filed in person or by mail. �� ,i4AN 2021 Form filed with:
Filing Date: Form must be completed and dated in the c lender 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. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Timothy R.Short and Andrea L.Short
Taxing District Key number/legal description Record number Page number
on O Q ( 26-12-35-200-001.793-004/W NE 35-2-10 1.00 AC D-10 2
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 eq ' ble owner?
$0.00 $124,000.00 es 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 t property in question:Annually Assessed
roperty 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
FI
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) AN 14 2021
4401 Theater Drive, Evansville, IN 47715 JAN
of assignee or other owner or holder of mortgage GJ,, ,
Address of assignee(number and street,city,state,and ZIP code) GIBSON COUNTY Au,..-_ �t3
Does applicant own property in y If yes,what county? What Taxing District? Has this de ction be requested If yes,state amount of deduction
other county ❑Yes No on property to Yes ❑ No
in Indiana? current year?
A person is not entitled o this deduction unless the person has a balance on the person's mortgag or co act 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)tha is the basis for the deduction.
. COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Aud' �����``5 A County Date a^r)
�vV� Gibson 1modaj& e
(/8 2( .
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 I contract buyer of the aforementioned property on date application ist filed.fy
led.
Signature(ow ers full n e) ) d/1/1606 .4 - Date(moy day,y ar)
F resident addr s f applicant(number and street,city,state,and ZIP code)
4205 E.350 S., Princeton, 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)
The penalties for nedury can include imnrisnnment lin to h..,+,..,+-.��u... --�-r__ .