HomeMy WebLinkAboutMortgage_Gentry (4) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
`°5 State Form 43709(R14/1-20) �/� L Y'' � 2022
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-` Prescribed by Department of Local Government Fin
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File Ma k
INSTRUCTIONS:inp p( �, �`'
To be filled in person or by mail. law` F filed with:
Filing Dates: Form must be completed and dated in the calendar year for which the deduction is s u ht�
Must be filed or postmarked with the County Auditor or County Recorder of the coup here 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)
Christopher P. Gentry and Amanda J. Gentry
Taxing Distrj�tl Key number/legal description 26-19-31-304-000.121-009/ Recojq number Pager
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the app icant the sole
assessment date,current year assessment date,current year date of application legal or quitable owner?
$52,000.00 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 th property in question: Annually Assessed
FILE
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Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and Zli3 )2 ]. 2022
4401 Theater Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgagev-h` ' __,
Address of assignee(number and street,city,state,and ZIP code) GIBSU aT t Ft
Does applicant own/property in any Ifyyyes,what county? What Taxing District? Has this deducti b n rs d If yes,state amount of
other county \\^ �� on property for deduction
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in Indiana? Yes 0 No rJ current year? Yes
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 offic that is e basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Sigr fpC ty Ai itor County \ Date(ontkt„ctay,;e
I/We certify under the penalty o erjury that the abov nd oregoing information is true and correct and that t 1eGGJJappli nt is a resident of Indiana
and ner/contract buyer oft aforementioned property on date application is filed.
S_ ign ur r u n � Date(month,day,year)
Full resident address of applicant(n ber and street,city,st and ZIP code)
310 S 3rd Ave., Haubstadt, IN 47639
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)