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STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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FOR DEDUCTION FROM ASSESSED VALUATION S�� O•� p �rZ`L
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�` State Form 43709(R13%10-1 S) RECEIVED �O
\+ ` Prescribed by Department of Local Government Finance
T- MAR 1 1 2022 File Mark
INSTRUCTIONS: V- Form filed with:
To be filed in person or by mail.
Filing Dates: 1) Real Property:Must be cc pleted` and dated in the calendar year for which the deduction is sought. Count Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is y
located on or before January 5 of the immediately succeeding calendar year. El 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.
Aooiicant(owner or contract buyer-see restrictions on reverse side(
Finnerty,Thomas L
Taxing District
I Key number/leaal description I Rl�ecord number Pa e n r
r � L
Princeton 26-12-17-101-001.117-028/KUNKEL ADD 28 \
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contra indebtedness unpaid as of 1Isthe applicant
applicant
the owner?sole
assessment date.current year assessment date,current year
date of 140.000.00 v Yes El o
93900.00 103917.00
If no.what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
I L E D Is-the property in question:Annually Assessed
If name on record is different than that of applicant,indicate below: x Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortaagee or contract seller MAR 16 2022
Evansville Teachers Federal Credit Union ��j-�� �
Address of mortgagee or contract seller(number and street,city.state.and ZIP coe a.pi .)
440C Theater Drive-Evansville-IN 47715 Name of assignee or other owner or holder of mortgage CstBSON OOUNTY AUDITOR
Address of assignee(number and street.city,state,and ZIP code)
Does applicant own prope in any If yes,what county? What Taxing District? Has this deducti. •'•-n requested If yes.state amount of deduction
other county on onrpropeertyrfor 0 Yes ❑No
in Indiana? ❑Yes No
A person is not entitled o th deduction unless the person has a balance on the person's mortgage or.•n -ct 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: tha is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of.
i 20 20 20 20 i 20 20
20
County \ Date f/2' r. yy!(Bar)r "
Signature of County Audito 1 I�\ ,( rS n r) vi �J
1Ny \Jt foregoinginformation is�and correct and that the applicant i a re dent of Indiana and
II We certify under the penalty of perjury that the a ve and
owner/contract buyer of the aforementioned property on date application is filed. year)
Date(month,day.
Si natu (owner's full nar�) � — '1���
rta( Tess �(p /t((nrX
Full ident address of applida+St(number nd street.city state.and ZIP code)
911 S Jefferson St.Princeton.I 670
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)