HomeMy WebLinkAboutMortgage_Harper (8) ,,,sti q. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS 'ounty Township Year
clr' l'4 yo FOR DEDUCTION FROM ASSESSED VALUATION 021
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s, P. State Form 43709(R14/1-20) LS�'� 2-
Na `�' Prescribed by De artment of Local Government Finance / File Mark
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INSTRUCTIONS: l�
To be filled in person or by mail. b t••e--- -z •iG• toZ-) Fd filed with:
Filing Dates: Form must be completed and dated in the c.dn.ar year for which the deduction is sought.
Must be filed or postmarked with the County 'uditor 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. tq Res
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Chelsea M. Harper
Taxing District Key number/legal description 26-12-03-400-004.752-027/ • Record number Page number
Assessed value of e�perty 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 le I or quitable owner?
$200,824.00 es ❑ 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'e property in question: Annually Assessed
►! Real Property El Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union
FI 'i EfD
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 FEB 2 6 20Z1
Address of assignee(number and street,city,state,and ZIP code) i/// C ri4J / t
+
Does applicant own property in any If yes,what county? What Taxing District? Has th I Irbuu!j ?j%T OR If yes,state amount of
other county on property for • deduction
in Indiana? El Yes ❑ No current year? Yes ❑ No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or c tra 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) at is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of Count Auditor County 1 Date(month, ,year)
I/We certify under the penalty of perjur he above and f regoing 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.
Signat e(owner' full ame) Date(month,day,year)
1V`- III A_ I1ti , A, 2,, 171., v •
Full re ident address of applicant(number and stree,city,state,and ZIP code)
841 N 350 East, 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)