HomeMy WebLinkAboutMortgage_Parks (3) <---- � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
," ''t%�r FOR DEDUCTION FROM ASSESSED VALUATION �1
6,'•Pr'•.:..:i= State Form 43709(R14/1-20) o \1 Gibson (� 21
i Prescribed by Department of Local Government Finance
�„�,� �} File Mark
INSTRUCTIONS: To be filed in person or by mail. �' cti 4 fi`�"\' �� V 1 Z• 26 . 20 2\
Form filed with:
Filing Date: Form must be completed and dated in the calenda 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. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jerry T. Parks
Taxing District Key number/legal description Record number Page number
Princeton 26-12-18-403-001.510-028 7.0 2
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant e \)
sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
$82,500.00 ®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: Is the property in question:Annually Assessed
®Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract sellerF E 1111
Evansville Teachers Federal Credit Union IL
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theater Drive, Evansville, IN 47715 FEB 26 2021
Name of assignee or other owner or holder of mortgage
p�_y/�p �1 n
Address of assignee(number and street,city,state,and ZIP code) ? Z c/1lZGC A A . �; r"7$4.)
GIBSON COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduct o been requested If yes,state amount of deduction
other county on property for
in Indiana? ['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 ntr t 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)
Mzck g Sow 2 . 2- 6 . 2.°2\
I/We certify under the penalty of perjury that the above and foregoing information is trite nd correct and that the applicant is a resident of Indiana and
owner/contract buyer of the afo ementioned property on date application is filed.
Sign Lure(owner's full na Date(month,day,year)
,f� c? ' I/ �i� 02/22/2021
F esi�d address of applicant(nu ber and street,city,state,and ZIP code)
118 Olive Drive, 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.
RECEIPT FOR FILING STATEMENT OF MO GE OR CONTRACT� INDEBTEDNESS
Name of applicant N m o o{iageeTIL'• ct ler
Jerry T. Parks var . ,ille r-a rr ederal Credit Union
Date filed(month,day,year) Amount of indebtedness Taxing District
2 . 26• 21 $82,500.opEB 26 2021 Princeton
Key number/legal description 1 O�'�
26-12-18-403-001.510-028 2ie2
Signature of County Auditor!Count Recorder, $?%'. ' " 6G-. ,j/k ,L,p,/ Date month,day,year)
m e c S - Ci
Ir) COUNTY AUDITOR �• 26, ' -O 2