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HomeMy WebLinkAboutMortgage_Martin (26) <,s strr�a. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESScounty Township Year et:' Nla FOR DEDUCTION FROM ASSESSED VALUATION �1 --. (�i Spcl ©2.Li 2021 t�' . ;,; /' State Form 43709(R14/1-20) J `'yam__ * Prescribed by Department of Local Government Finance File Mark Ills INSTRUCTIONS: To be filled in person or by mail. Form filed with: Filing Dates: Form must be completed and dated in the calendar year for which the deduction is sought. 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 ae first due County Auditor and payable. ❑ County Recorder See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Aaron J. Martin and Erika D. Martin Ta , Distr,t Key number/legal description 26-18-36-300-002.787-024/10129 S. Quail Record number Page number • Xing, Haubstadt, Indiana 47639 2/'61: J .e sed value of rea prop rty as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole P PP i:sessment date,current year assessment date,current year date of application leg I quitable owner? $237,000.00 Yes 0 No If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with who If name on record is different than that of applicant,indicate below: s t property in question: Annually Assessed Real Property 0 Annually Assessed s' I c• e Home(IC 6-1.1-7) Name of mortgagee or contract seller a' __• 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 9 20211 Name of assignee or other own ✓ older o ort ag ,,.<_.0 � c /off Address of assignee(number an.s t,city,state,and ZIP code) GIBBON .�/(v couNn,AUDt o Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of other county on property for deduction in Indiana? 0 Yes 0 No current year? Yes 0 No A person is not entitled to this deduction unless the person has a balance on the person's mortgage or co tract 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: 1 20 20 20 20 20 20 20 Signatu �Coun Au ' r County Date(month,day,year) A 1lAd I/W c if under the penalty o perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and o 1 con act b yer of the aforementioned ro ert on date a lication is filed. Si natu owner's ull n ) Date(month,day,year) Full r sident a ress of applicant(number and street,city,state,and ZIP code) a '7)ZYL 2,- I - I 10129 S Quail Xing, Haubstadt, IN 47639 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.