HomeMy WebLinkAboutMortgage_Partridge �- STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS c unty Township Year
•f �_\ FOR DEDUCTION FROM ASSESSED VALUATION Q
2021
(! State Form 43709(R14/1-20) G 3��
Prescribed by Department of Local Government Finance File Mark
INSTRUCTIONS:
To be filled in person or by mail. Fo m ed with: ,
Filing Dates: Form must be completed and dated in the calendar year for which the deduction is sought.
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 ae first due County Auditor
and payable. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Lisa Partridge and Matthew Partridge
Taxing District Key number/legal description 26-19-18-400-002.474-025/7440 S Sunrise Record number Page number
/ FortS Branch, Indiana7648
21)647,00(' ry'0 Dr.7446 SunriseseBranch,Fort Branch, Indiana 47648 ,/
26-19-18-400-002.474-025 a 1-6`f 3 -,
26-19-18-400-002.475-025
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the appli the sole
assessment date,current year assessment date,current year date of application legal or uitable owner?
$68,000.00 Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spou ,indicate with whom
If name on record is different than that of applicant,indicate below: I th roperty in question: Annually Assessed
eaI Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union Pi
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)4401 Theater Drive, Evansville, IN 47715 LED
Name of assignee or other owner or holder of mortgage \ D`C
Address of assignee(number and street,city,state,and ZIP code) J O 202�
G/gSn/V
Does applicant own property in any If yes,what county? What Taxing District? Has this de ion b n reques(4dO N� ate amount of
other county on property for yd"
in Indiana? ❑ Yes No current year? Yes o TOR
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or roc indebtedness tha " corded in the county
recorder's office(including any home equity line of credit that is recorded in the county recorder's office) at is e basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 `20 20 20 20
Signature of County Auditor y Countyyd-
N Date( onth d ,y r)
//7;_4.a//2 iie J%r*e) •lOff/ '-!1/,`•--`', /`I/We certify under the penalty of perjury that the above and foformation is true and correct and t at t e appl ant is a r&siiient of Indiana
and owner/contract buyer of the aforementioned property on ation is filed.
Signature ner's full me)' Date(month,d�yar4
� (odAL4it rn(tb� 11QL
Full resident address of applicant(nu ber and street,city,state,and ZIP code)
7440 S Sunrise Dr., Fort Branch, IN 47648 9.- —14-4-kos.JuA( ,,16y.-- s-A--- }Rrcx,-tJ- .,,1,-. 4--)4y
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.