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HomeMy WebLinkAboutMortgage_Engle (2) s*o. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ounty Township Year 4'!'''''.:.;.Z.::, % FOR DEDUCTION FROM ASSESSED VALUATION � �\, 2022 f-411Ntli I. � � \\ ;/ State Form 43709(R14/1-20) "l '��_.,/i Prescribed by Department of Local Government Finance File Mark I sib INSTRUCTIONS: To be filled in person or by mail. Form filed 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 County Auditor property is located on or before January 5 of the calendar year in which the property taxes ae first due and payable. ❑ County Recorder See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) John R. Engle and Amy L. Engle Taxing District ©� Key number/legal description 26-18-36-300-002.585-024/ 1340 W Chukar Record number Page number Holw. Haubstadt, Indiana 47639 20 a I 30 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? $225,600.00 ❑x Yes ❑ No If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom If name on record is different than that of applicant,indicate below: Is the property in question: Annually Assessed O Real Property ❑Annually Assessed Mobile Home (IC 6-1.1-7) Name of mortgagee or contract seller F L Evansville Teachers Federal Credit Union ) Tj—, F) Address of mortgagee or contract seller(number and street,city, state,and ZIP code1 ■�—i 4401 Theater Drive, Evansville, IN 47715 Name of assignee or other owner or holder of mortgage MAR 1 7 2022 Address of assignee(number and street,city,state,and ZIP code) ;7022 Does applicant own propertyin anyIfyes,what county? What Taxir{gl�i s-tYiigrde$,u�Q!1 been requested If yes,state amount of COt I*00 If9 deduction other county in Indiana? ❑ Yes ❑ No current year? Yes ❑ No A person is not entitled to this deduction unless the person has a balance on the person's mortgage or co r 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 Auditor County �\ (p�gnt4�Ve O, Date ► ^��J • I/We certify unde r.%'�eg �• 9-,!;' , '7i he above and foregoing information is true and correct and that e applicant is a resident of Indiana and owner/contract buyer of the aforementioned property on date,application is filed. Date(mo th,d y year) Signature is f ll name L � // 31' t � ,zz Full rest nt address of applicant(numb9nd street,city,state,and ZIP code) 1340 Chukar Holw., 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) —. _ __- s,r ncro,ry can include imprisonment up to two and a half years and a fine not to exceed$10,000.