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HomeMy WebLinkAboutMortgage_Mundy "'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year I FOR DEDUCTION FROM ASSESSED VALUATION � w �,�� Gibson 02.-S 2021 '.:, State Form 43709(R14/1-20) ."r Prescribed by Department of Local Gove nment Finance File Mark INSTRUCTIONS: To be filed in person or by mail. .33 e 1\40 a W LG i Form filed with: Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. © 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) William E. Mundy and Heather D. Mundy Taxing District Key number/legal description R. numbert/Q Page nu( /mber Princeton 26-11-11-300-004.032-028/ PT SW 11 2 11 5.00 AC f_'"/,2 /141JQy 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 r uitable owner? $0.00 $142,000.00 Yes 0 No If no,what is his/her exact share of interest? . J n ed �m other than spouse,indicate with whom FIf name on record is different than that of applicant,indicate below: I�t property in question:Annually Assessed Real Property ❑ Annually Assessed DEC 0 2 2021 Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller Evansville Teachers Federal Credit Union l i Address of mortgagee or contract seller(number and street,city,state,and 7 Qel a. ,14,'A..4.ici✓i.W 4401 Theater Drive, Evansville, IN 47715 GIBSON COUNTY AUDITOR Name of assignee or other owner or holder of mortgage 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 deduction b n requested If yes,state amount of deduction other county on property for Yes 0 No in Indiana? ❑Yes 0 No current year? _ A person is not entitled to this deduction unless the person has a balance on the person's mortgage or c n act 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) h is the basis for the deduction. COUNTY AUDITOR Deduction approved in the amount of: 20 20 20 20 20 20 Signature of County Auditor /�,� _. County Date(mo th,d ar ' �(, 21 Gibson 1.2i I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resi ent Indiana and owner/contrac bu of t e aforementioned property on date application is filed. Signature(owner's ul n C._., DatI,(monk,day'yetr) Full resident address of applicant(number an treet,city,state,and ZIP code) 1 G.- 2042 W. 50 S., Princeton, IN 47670 Date(month,day,year) Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 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.