HomeMy WebLinkAboutMortgage_Phillips (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS f unty Townshi Year
FOR DEDUCTION FROM ASSESSED VALUATION e I P1 a `Z - 2022
State Form 43709(R14/1-20)
Prescribed by Department of Local Government Finance File Mark
INSTRUCTIONS:
To be filled in person or by mail. For fi 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 County Auditor
property is located on or before January 5 of the calendar year in which the property taxes ae first due
and payable. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Trent L. Phillips and Emily A. Phillips a__Taxing District 0 f1 Key number/legal description 26-11-13-400-000.506-027/ Re rd number Page number
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is Is the applicant
thee sole
l
assessment date,current year assessment date,current year date of application 9
er?
$240,000.00 iO'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 the property in question: Annually Assessed
E Real Property 0 Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
EvAddress
moTertgagese
contract
Creditr Union IL�'Address of mortflagae 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
FEB 7 2022
Address of assignee(number and street,city,state,and ZIP code) �,/
Does applicant own property in any If yes,what county? What Taxing District? Has this dedu n en retq�y a4„,„9„,,_ nt of
other county /� on property for MITOR
in Indiana? 0 Yes lg No current year? Yes 0 No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or co rac 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 e basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 ) 20
Signa
ture County Aidito " ,- County r kO'Sd Date(month,day,7,
II e certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana
and owner/contract buyer of the aforementioned property on date application is filed.
i ature(owr ' f 11 name) / - Datel(r1oo ,day, er)
Full resident address of applicant(number and street,city,state,and ZIP code)
1368 S 100 W, Princeton, IN 47670
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.