HomeMy WebLinkAboutMortgage_Jarboe (4) ,. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDN SS County Township Year
�7 '-. . FOR DEDUCTION FROM ASSESSED VALUATION c may,( Township 'r��
�s.-�.%. State Form 43709(R14/1-20) C7"�'""' Gibson CO G.- (!�2 2
Prescribed by Department of Local Government Finance
INSTRUCTIONS: To be filed in person or by mail. q-l.Ju k 21712-2 File Mark
Form riled with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. m 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. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jacob Jarboe
Taxing District Key number/legal description Record numb r Page
Princeton 26-12-07-201-001.488-028 '`? 2- 1(
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 or equitable owner?
$103,075.00 0Yes ❑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
0 Real Property ❑Annually Assessed
.DMobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller17 L E Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) FEB 0
4401 Theater Drive, Evansville, IN 47715 9 2022
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) GIBSON COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deductio be requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes ®No current year? es ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or n act 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 th is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor`�; County '�O� Date(moai d,� ye )2��l2 "( 2�
I/We certify under the penalty of perjury thaiove and foregoing information is iwegnd correct and that the applicant i a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signatur er' na Date(month,day,year)
02/03/2022
Full esident address applicant(number and street,city,state,and ZIP code)
520 N Gibson St., Princeton, IN 47670
Person authorized by duly executed Power of Attorney or by IC 8-1.1-12-0.7 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.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name of mortgagee or contract seller
Jacob Jarboe Evansville Teachers Federal Credit Union
Date filed(month,day,year) Amount of L D Taxing District
'Z- el• 12- $ 03 Princeton
Key number/legal description 2.7 S
26-12-07-201-001.488-00 8 FEB 0 G
Signature of Co my A ditor/C n` e er 91 Date(month,day,year)
GIBSON COUNTY , uUiTOR