HomeMy WebLinkAboutMortgage_Robb (9) <0-E.-- STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�. County Township Year
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FOR DEDUCTION FROM ASSESSED VALUATION
. i'i• State Form 43709(R14/1-20) Gibson Patoka 2022
--4 Prescribed by Department of Local Government Finance FEB 0 1 2021
G..
r' �v_ File Mark
INSTRUCTIONS: To be filed in person or by mail. ull• ' ;��
Form d with:
Fling 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)
Pamela A. Robb
Taxing District Key number/legal description Record number Page number
028 26-12-06-401-000.022-028/Northbrook Hills 32, Gibson County , 0000�S
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?
$85500.00 WI Yes ❑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
®Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4405 Theater Drive Evansville, IN 47716
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in a If yes,what county? What Taxing District? Has this deduction be requested If yes,state amount of deduction
other county on property for
in Indiana? Li Yes No current year? Yes ❑No
A person is not entitled o 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
Signature of County Audi or County ' Date(month,day,year)
I/We certify under the penalty of perjury tha above and foregoing information is t nd correct and that the applicant is a resident of Indiana and
own r contract buyer of the aforeme ' ned property on date application is filed.
Signs re(o ner's full name) ci _ Date(month,day,year) -
�} 1/14/2021
Full resident address of applicant(number and street,city,state,and ZIP code)
1511 Cottonwood Drive, 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)