HomeMy WebLinkAboutMortgage_Camden (2) ,.0 R, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
., t FOR DEDUCTION FROM ASSESSED VALUATION
'.''''," t h State Form 43709(R14/1-20)
` -A;, Gibson Princeton 2021
•i, Prescribed by Department of Local Government Finonro - -
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File Mark
INSTRUCTIONS: To be filed in person or by mail. Form filed with:
Filing Date: Form must be completed and dated ��\�
Must be filed or postmarked with the �J \ (� County Auditor
Drawer NO property is
located on or before January 5 of th payable. ❑ County Recorder
•
See reverse side for additional instructions and quail Q'I �,�
Applicant(owner or contract buyer-see restrictions on rev .e Card �T®• �'f
Brian & Katherine L. Camden •
Taxing District Key number/legal description Record number Page number
Patoka Township 26-12-05-400-000.262-027 .Dm g L..p LA
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?
$ 198,000 VIYes ❑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) FF
s 4&:1)
.28 1�2j •
Name of assignee or other owner or holder of mortgage e sO�
c
Address of assignee(number and street,city,state,and ZIP code) C OtiQ r
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction b�Ited If yes,state amount of deduction
other county on property for
in Indiana? Yes ®No current year? ®❑ Yes t No
A person is not entitled to 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 Auditor County Date(month,day,year)
1\ & M Gibson 2/23/2021
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
ig ature owner's full name) Date(month,day,year)
�� d
Full real t a d� ress of applicant(number and street,city,state,and ZIP code)
1492 E Taftown Road, 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)