HomeMy WebLinkAboutMortgage_Bales ^•ko STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
d FOR DEDUCTION FROM ASSESSED VALUATION 'rQ
kI ` State Form 43709(R14/1-20) ,(`�- C71.•� Gibson 0 2, `2-02`
-- •' Prescribed by Department of Local Government Finance 8 0
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Critcjiiki
File Mark
INSTRUCTIONS: To be filed in person or by mail. \ ?v2J
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for hick the d uction is sought. 0 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)
Nathaniel A. Bales and Deborah G. Bales, husband and wife . .
Taxing District Key number/legal description Record number Pa m r
Montgomery 26-11-17-400-000.586-021 20 9-1b O f
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?
$180,000.00 WIYes ❑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 FELE
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theater Drive, Evansville, IN 47715 FEB 1 0 2021
Name of assignee or other owner or holder of mortgage
ya ''
Address of assignee(number and street,city,state,and ZIP code) pUDI70R
GIBSON COUNYY
Does applicant own property in any If yes,what county? What Taxing District? Has this dedu••"on•-en requested If yes,state amount of deduction
other couty ❑Yes ®No ..Yes on property for
in Indiana? current year? 0 No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or c•n :ct 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 Co1unVAudi r- County • Date(month,day*
1/We certify under the penalty o perjury that the above and foregoing information[sue and correct and that the applicant is a resident of Indiana and
owner!contract buyer�(f the aforementioned property on date application is filed.
(:)? natur (owner's full name) / yol Date(month,day,year)
P. NA/
I/ 02/04/2021
F I res dentiaddress of applicant i pp cant(number and street,city state,and /P code)
• 1220 S Old SR 65, 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 perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.
pp RECEIPT FOR FILING STATEMENT OF MORTGAG9 O RA �B DNESS
Name of applicant Name o o ee r c t ct I t
Nathaniel A. Bales and Deborah G. Bales Evansvil a eachers f-ederal Credit Union
Date filed(month,clay,year) Amount of indebtedness ,T.A.iiilg District
2. 7\,7-021 $180,000.00 • FEB 1 0 Litilbntgomery
Key number/legal description
26-11-17-400-000.586-021 i'/l„..fia,.f C(.. .Z .0 ::�rwJ —2_o2\ - Cc' '+
Signature of,County/auditor/ ounty(r CounGIBSON COUNTY AUDITOR Date(month,d year)
Pl\W G'son 2. 1U' 1-0'0