HomeMy WebLinkAboutMortgage_Bennett (5) -A7 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County TowriStr2i.iN Year
State Form 43709(R14/
•TIF• ----'!.::\, FOR DEDUCTION FROM ASSESSED VALUATION 0 2022
'11 T3101\
1-20)
? Prescribed by Department of Local Government Finance File Mark
fNS TRUCTIONS:
To be filled in person or by mail. Fo f 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)
Christina Kay Bennett
Taxing District it,,i 2--1 Key number/legal description 26-11-12-101-001.053-028/ Reccy number Page number
Q.) . . 01-5(116
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal o5.equitable owner?
$86,000.00 a: Yes 0 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
eal Property O Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union FILED
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
F EB 7 2i122
Address of assignee(number and street,city state,and ZIP code)
c"vr
.h,_
Does applicant own property in any If yes,what county? What Taxing District? Has this deducti sta..„ tate amount of
other county on property fo SON COUNTY A dill on
in Indiana? El Yes ISI7No 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 c 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) at i he basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signatur of County Auditor 24.7-County - Date(mon h,day Year) .: ,./.7,41,2„ )...
i/We certify un v er the penalty of perjury that the above and foregoing information is true and correct and tha the applicant is a resident of Indiana
and owner/contract buyer of the aforementioned property on date application is filed.
Si nature(owner's full name)
c
QYA\
Fu I resident address of applicant(number and street,city,state,and ZIP code) Dale l(rprtc odiyAr)
An.fiel
'LI-307 N 5th Ave., 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.