HomeMy WebLinkAboutMortgage_Riley (11) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS oun TownshipYear
"�' � tY
-��� � FOR DEDUCTION FROM ASSESSED VALUATION \
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a State Form 43709(R14/1-20) Q _J 2022
Prescribed by Department of Local Government Finance File Mark
INSTRUCTIONS: (� ` o\ b a\
To be filled in person or by mail. lJ� � n For d 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. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Hunter Michael Riley and Kaleigh Hooker
Taxing DistriC) t Key number/legal description 26-19-19-103-000.377-026/ Record numb P e n r
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?
$123,500.00 es 0 No
If no,what is his/her exact share of interest? T F
If owned with someone other than spouse,indicate with whom
1
If name on record is different than that of applicant,indicate below: 1 L J ■ / I�s t,�e"property in question: Annually Assessed
L/ ® Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller JAN 2 1 2022
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city.st and ZIP code". iX+��nab 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 an If yes,what county? What Taxing District? Has this deduc'o' .een requested If yes,state amount of
other county on property for deduction
in Indiana? ❑ Yes No current year? a Yes 0 No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or..ntr.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 r the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 120 20 20 20
SigO ur� ditor County Date(month 7 year)
�I/We certify under the pen perjury that the above and f reg ing information is true and correct and that the1app�i nt is a resident of Indiana
and owner/contract buyer of the aforementioned property on c to application is filed.
Sjgr*ature(own r' full naTe) % 'c w Date(m t ,day,year)
X (own
applicant per 111 7r
Full residen address of applicant(numbe rid street,city,state,and ZIP code)
1012 S Center St., Fort Branch, IN 47648
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)