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HomeMy WebLinkAboutMortgage_Elpers (42) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year f.,e"" • FOR DEDUCTION FROM ASSESSED VALUATION P 2021 Gibson ,--State Form 43709(R14/1-20) RECEIVED , tf Prescribed by Department of Local Government Finance File Mark ©1 INSTRUCTIONS: To be filed in person or by mail. "\ 'T' DEC 1 5 2021 or filed with: Filing Date: Form must be completed and dated in the calendaryear 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. aunty Recorder See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Emily A. Elpers Key number/legal description Record number Page number Taxing District ^r�\ 6 1�G (� 26-11-12-101-001.075-028/Lt 133+ N 1/2 Lt 134 Tower Heights ! t✓ oka "-"�� (1-58) Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is is theal applicr ant the sole assessment date,current year assessment date,current year date of application 9 $97,000.00 $146,470.00 Yes ❑ No If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom property in question:Annually Assessed Is th 7if name on record is different than that of applicant,indicate below: R CIeal Property Annually Assessed Mobile Hame(IG 6-1.1-7) Name of mortgagee or contract sellerF ILED Evansville Teachers Federal Credit Union Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 2U21 4401 Theatre Drive, Evansville, IN 47715 DEC 2 Name of assignee or other owner or holder of mortgage ; iiirS4-4.414) Address of assignee(number and street,city,state,and ZIP code) 11 UNT'f ^`)�tTaF� • Does applicant own property in y If yes,what county? W het i axing District? Has this deduc n b requested If yes,state amount of deduction other county on property for YES 0 No in Indiana? ❑Yes No current year? A person is not entitled o this deduction unless the person has a balance on the person's mortgage or ont ct 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 1 20 I 20 20 r County I Date(month,da ar r� Signature of County Auditor '' -y� VY -S / _ \ ",a (,,• )W3A_ \11�1�"t,\ l``'�i Gibson I/We certify under penalty of perjury that the abo foregoing information Is true and correct and that the applicant is a rest ant of I diana and owner/contract buyer of the aforementioned property on date application is filed.Signature(owner's full name) I Date(month,day,year) )I (-j^a `�. E,n numb Full resident addres of applicant(number and street,city,state,and ZIP code) 306 N Fourth Ave, Princeton, IN 47670 I 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.