HomeMy WebLinkAboutMortgage_Gross 11,5, ,,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownship
d ,\k FOR DEDUCTION FROM ASSESSED VALUATION Year
xl :: ®Z`1 ?O2 J
r - State Form 43709(R14/1-20) Gibson
;, -d• Prescribed by Department of Local Government Finance p�4 'mot it =�
�,,__,•
INSTRUCTIONS: To be filed in person or by mail.�'lv^^I/P1 1 FEB 2 2 2021 File MarkForm filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. m 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) .
Bradley A. Gross and Christina E. Gross TEL- ' --
Taxing District Key number/legal description RR corrdd number P nu er
JOhnson 26-23-16-200-002:603-024 1�J2, q'
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the ap nt the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
$425 ,000 .00 ID 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: ' 'e•op:rty question:Annually Assessed
pit& • •;* D Annually Assessed
'' Is Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller • .
Evansville Teachers Feiera& rredit Union FEB 222021
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theater Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage / "` -ir[SJ
GIBSON COUNTY AUDITOR
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any If yes,what county? What Taxing District? Has this deductio b en requested If yes,state amount of deduction
other coun
in Indiana? ❑Yes L.No currrentyear?or Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or ont ct indebtedness that is recorded in the county
recorder's office(including any home equity fine 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 Auditor1r /1'w County Date(month,day,year)
sdC\ . 2.22. `imZ1
I/We certify under the penalty of perjury that the above and foregoing information is trued correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signatu owner's full name) Date(month,day,year)
it , ,,,tm-,v-- E E . e. a—�, /4 n,�.3.0) A' 17—�1 DA
Full resident address of applicant(number and street,city,state,and ZIP code)
1649 E Lincoln Pass, 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.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name of mortga•9ee• ..• r ct seller
Bradley A. Gross and Christina E. Gro 4 s ,.. 1'i'. -achers Federal Credit..Uni(
Date led(month,day,year) Amount of indebtedness • ,- ' axing District
' Z2 • ri-o2 $425 ,000 .00 Johnson
Key number I legal description FEB 2 2 2021 1
26-23-16-200-002.603-024 2.021-- S 1G
3
Signature of County Auditor/County Recorder
y�` ,�,.��Ay�� ( Cou�nh�i��p Date month,day, ear) 2 I
�' f wCJ`�'�- �Y1LrKYt Lni. ,.�i C.v;' �` 61-'
G I3SON COUNTY AUDITOR