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HomeMy WebLinkAboutMortgage_Shoemaker (3) „ _ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year ..:, FOR DEDUCTION FROM ASSESS D VALUA ION ;1 State Form 43709(R14/1-20) �TG�4 RECEIVED Gibson Johnson 2022 Prescribed by Department of Local Government once , Poi �Cjo FEB 1 5 2022 File Mark INSTRUCTIONS: To be filed in person or by mail. Form filed with: Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. © 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. © County Recorder See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Steven L.&Cynthia Shoemaker Taxing District Key number/legal description Record number Page number Johnson 26-18-36-300-001.818-024 2022 321 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? $ 228,000 ©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 thaa applicant,of applicant,indicate below: is ate property in question:Annually Asaesscd ®Real Property ❑Annually Assessed FILED Mobile Home(IC s_,.,_7) Name of mortgagee or contract seller Evansville Teachers Federal Credit Union Address of mortgagee or contract seller(number and street,city,state,and ZIP code) S . e_ \ a �\ FEB 15 2022 � ,-) Name of assignee or other owner or holder of mortgage // e�./ `S�C e VV.\ e 1\ Address of assignee(number and street,city,state,and ZIP code) ✓/h� a. ,YYAS -, L— 6 Q CY O C GIBBON COUNTY AUDI' t_ .2_2 g2 r Does applicant own property in any If yes,what county? What Taxing District? Has this dedu,,.,....___ other county 1 on property for I in Indiana? ” Yes IN NO %A eA r r- ) C current year? Yes El No ? - _ I A person is not entitled to this deduction unless ine person has a balance on the person's mortgage or contract indebtedniis.4 i'if 1s readrtret VrPthlOca u ity0 recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deduction. COUNTY AUDITOR Deduction approved in the amount of: 20 20 20 20 20 20 20 Signature of County Aud'or ('� County Dal/tonal ,year) M � Gibson .� /1!0 1/We certify under the penalty of p ry that the above and foregoing information is true and correct and that the appli s a r sident of Indiana and owner I contract buyer of the aforementioned r+rnc.ert',.-n aate apir€icatien is filed. Signature(owner's full name) 1 Date(month,day,year) Full resident address of applicant(number and street,city,state,anti PP code) 1197 W 1000 S, 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) 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 Steven &Cynthia M Shoemaker Evansville Teachers Federal Credit Union 33 Date file orq h day,year) Amount of indebtedness Taxing District j 0 /l�/ '11► ^(�, $228,000 Johnson ,�,,! ITI Key num er lhegal description '1 `) ,^y 26-18-36-300-001.818-024 t'�,0 2_' -. rn Signature of County udito Coun Recorde/ County Date(-m7onth,de , r `�1S/tV(y{,�� Gibson G-- 1 C j_,e2_