HomeMy WebLinkAboutMortgage_Bates (5) �, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
`f-cnk FOR DEDUCTION FROM ASSESSED VALUATION
N. Y f ;y State Form 43709(R11 6-09) Gibson Oakland City2021
vi.,,,,,,,, , Prescribed by Department of Local Government Finance RECEIVED
tale ...—
INSTRUCTIONS: &NA )o1 ' 1 vokkp FEB 012021 File Mark
To be filed in person or by mail.
Filing Dates: 1.) Real Property: Must be completed and dated in the calendar year for which the deduction is sought. orm filed with:
Must be filed with the County Auditor or County Recorder of the county where the property is located
on or before January 5 of the immediately succeeding calendar year. County Auditor
2.) Mobile/Manufactured Home not assessed as real Property: Must file with the County Auditor of the 0 County Recorder
county where the property is located during the twelve(12)months before March 31 of each year the
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
* Timothy R.Bates and Kaylee R. E person
Taxing District 0 04 (Key number/legal descriptignb ^) ��^�� ®QOO�16�7 Record number Pay@gt' er
* HARDEN ADD#2 1 T eic U
Assessed value of real property as of Mortgage/Contract indebtedness unpaid Mortgage/Contract indebtedness Is the applicant the sole
March 1,current year as of March 1,current year. unpaid as of date of application legal or equitable owner?
* $0.00 *-$fir' 12.p138`� * $0.00 ❑k 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
❑!c Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
* Evansville Teachers Federal Credit UnionF I Address of mortgagee or contract seller(number and street, city, state, and ZIP code) L j '."D
* 4405 Theater Drive,Evansville, IN 47716
Name of assignee or other owner or holder of mortgage FEB 0 1 %r1
Address of assignee(number and street,city,state,and ZIP code) A
gediall
.Pird‘fgel
Does applicant own property in any other In yes,what county? What TaxirG r U 1WaaA(I I'-'fiction been requested on property
county in Indiana? for current year?
❑ Yes 0 No 0 Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of Courh 'tor -. County a1,- Daje(m; I nthcay tear)
I/We certify under the penalty of perjury that the above and foregoing information is tr and correct and that the applicant is1 a residentnt of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sign ur overt 11 name) Date(month, day,year)
'" Full resident address of applicant(number and street, city, state, and ZIc ode)
* 731 Polk Drive,Oakland City,IN 47660
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)