HomeMy WebLinkAboutMortgage_Ridge (2) ' ,e STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS CountyTownshipYear
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,,�,, FOR DEDUCTION FROM ASSESSED VALUATION I \�� �2 � 2021
State Form 43709(R14/1-20) File Mark
Prescribed by Department of Local Government Finance
INSTRUCTIONS: Form filed with:
To be filled in person or by mail.
Filing Dates: Form must be completed and dated in the calendar year for which the deduction is sought. El
Must be filed or postmarked with the County Auditor or County Recorder of the county where the County Auditor
property is located on or before January 5 of the calendar year in which the property taxes ae first due 0 County Recorder
and payable.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Charles P. Ridge and Trenda L. Ridge g Record number Page number
Taxing District Key number/legal description 26-18-13-200-000.125-025/587 W 650 S. �o a I ag a b r
Fort Branch, Indiana 47648
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is Is theal applicant
r pllicant the
e sole
assessment date,current year assessment date,current year date of application 9
$176,000.00 O Yes ❑ No
If no,what is his/her exact share of interest? I 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
Ill Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgaTegce hor Federal Cr F ILED
Evansville Teachers Federal Credit Union
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 DEC 2 2 2021
Address of assignee(number and street,city,state,and ZIP code)
z.L a. ` d)
Does applicant own property in any If yes,what county? What Taxing District? iHig4 C9llld o,+ ,' 'nf41t043t6>,it If yes,state amount of
on property for deduction
in Indiana? ID 0 No other county current year? FA Yes 0 No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or • tra 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:
I 20 I 20 I 20 I 20 I 20 I 20
20 _ 'County \ Date(mootp,day),y ar)
Signature of Cot"(Aud' r `Ls ^ 1 \ li,Dzt Z
. ��� �� cant is a resident of Indiana
1/We certify under the penalty of perjury that the abov a d foregoing information is true and correct and that t e app
and owner/contract buyer of the aforem ,ioned prope y on date application is filed.
Date(month, ay,year)
Signature(own rs full
'Date
J,s J 21
Full resident address of app cant(number et,city,state,and ZIP code)
587 W 650 S,Fort Branch, IN 47648 (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 oeriury can include imprisonment up to two and a half years and a fine not to exceed$10,000.