HomeMy WebLinkAboutMortgage_Madison _*i}4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATIONc ^/ ?A 22-
t i ' State Form 43709(R13/10-15) V O C.�
,r, d/- ECEIVED Prescribed by Departme Local Government Finance MAR 1 1 2022 File Mark
INSTRUCTIONS: K �_ Q vt �1
To be filed in person or by mail. 1\ I V�`'� l� Form filed with:
Filing Dates: 1) Real Property:Must be co ted and dated in the calendar year for which the deduction is sought.
Must be filed or postmarks ith the County Auditor or County Recorder of the county where the property is County Auditor
located on or before January 5 of the immediately succeeding calendar year. ,❑ County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county
where the property is located during the twelve(12)months before March 31 of each year the deduction is sought.
See reverse side for additional instructions and qualifications.
Aoolicant(owner or contract buyer-see restrictions on reverse side)
Madison,Caden and Alstatt,Sabryn _
Taxing District 1 Key number/legal description Record number Pa nun r
Patoka W 26-11-14-200-003.690-027/COLUMBIA VILLAGE SEC 4 29 PT/28 PT i7 _ ZZ-- ��
Assessed •
value-- property
val of real property as f 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 aoolication legal or eauitable owner?
110400.00 0.00 151.515.00 x 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 the property in question:Annually Assessed
FILE
IL x Real Property ❑ Annually Assessed
Mobile Home(IC 6_1.,_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) MAR r j 2022
4405 Theater Drive.Evansville.IN 47715
Name of assignee or other owner or holder of mortgage
��a. .14-te
Address of assignee(number and street,city.state.and ZIP code) IBSON COUNTY AUDITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction n requested If yes,state amount of deduction
other countyon property for
in Indiana? ❑No
❑Yes CI current year?
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or ntra 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)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 Audi
(t�o(r�+ A� _ `,(/�^ County �. .Th Date,(srp �,q� ey ar)
I/We certify under the penalty of perjury that the -•• = and foregoing information is tru d correct and that the applicant a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sig ure(o er's Si I name) at month,day.year)
oa / 111c
ull sident a dress•f ao i nt(number and street.city state.and ZIP code)
1809 W Essex Place.Pr ceton.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)
- --- - -• .. •_ •..•. •.,'rent u•to two and a half years and a fine not to exceed$1O.000.