HomeMy WebLinkAboutMortgage_Shipley ,�,,i t.p... STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Founty Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
1 �'`� State Form 43709(R14/1-20) G��'� WI—
File 2022
"4„ iii� Prescribed by Department of Local Government Finance Mark
INSTRUCTIONS:
To be filled in person or by mail. F m ed 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
property is located on or before January 5 of the calendar year in which the property taxes ae first due County Auditor
and payable. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Dina J. Shipley and Leonard A. Shipley
Taxing District Key number/legal description 26-11-15-202-004.797-027/566'Cathy Dr. Record number Page number
Princeton, Indiana 47670 a6 �a l 1 3
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 stable owner?
$195,483.00 es ❑ 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 prop in question: Annually Assessed
FiL Property ❑Annually Assessed
Name of mortgagee or contract sellerED Mobile Home(IC 6-1.1-7)
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code
4401 Theater Drive, Evansville, IN 47715 AR 1 7 2022
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city, tate,and ZIP code) C'tBSON COU y pu�+�c:yr )
DITOR
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of
other county on property for deduction
in Indiana? ❑ Yes 0 current year? ❑ Yes No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or contract 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 I 20 20 20 20
Signature of Count uditor Q ) County TOr\
Date(T�oy�t cyyea ��I/We certify under the penalty of perjury that the above andng information is true and correct and that t l aappplliicInt is a resident of Indiana
and owner/contract buyer of the aforementioned property opplication is filed.
Signature(owner's full name) �(t��` Date(m cry ye��j�
Full resident of ppl' ant(number an street, •y,state,and ZIP code) l:L• ' ^Vil
566 S Cathy Dr., Princeton, 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)
rho,.e„ ,.;,,,r .--,••a- ,-.-,_•---,....-..„F-1 r.,t,,n and a half years and a fine not to exceed$10.000.