HomeMy WebLinkAboutMortgage_Shepler (3) its STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS 4ounty Township Year
4'�• -'-=_. FOR DEDUCTION FROM ASSESSED VALUATION son 0 2'$ I 2022
j, ' ' State Form 43709(R14/1-20)
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,, /r' Prescribed by Department of Local Government Finance File Mar
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INSTRUCTIONS:
To be filled in person or by mail. F r 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. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
James B. Shepler and Melanie N. Shepler
Taxing District Key number/legal description 26-12-06-401-000.733-028/1610 Brentwood Record number Page number
Dr. Princeton, Indiana 47670
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26-12-06-401-000.733-028
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the ap nt the sole
assessment date,current year assessment date,current year date of application legal o quitable owner?
$273,100.00 Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spo se,indicate with whom
If name on record is different than that of applicant,indicate below: Is t prop n question: Annually Assessed
Real ty 0 Annually Assessed
ile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union /114� .�
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) l
4401 Theater Drive, Evansville, IN 47715 G7Q3 �^F_ "- 04,
Name of assignee or other owner or holder of mortgage O Co,,, 1"11^
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Address of assignee(number and street,city,state,and ZIP code) '9C/�
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Does applicant own property in any If yes,what county? What Taxing District? Has this dedu .o een requested R If yes,state amount of
other county on property for deduction
in Indiana? 0 Yes No current year? Yes 0 No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or co 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)th t is he basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,year)
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I/We certify under the penalty of perjury th('ft the above and foregoing in ormation is true and correct and that the applicant is a resident of Indiana
and owner/contract buyer of the aforementioned propert on date application is filed.Signatur ful 'n�e) Date(month day,year)
Full resident a ss of applicant number and street,ci y,state,and ZIP code)
1610 Brentwood 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)
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