Loading...
HomeMy WebLinkAboutMortgage_Fryman STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year •�� ©�. ; FOR DEDUCTION FROM ASSESSED VALUATION I'�San c� 2022 .{IT .f `} State Form 43709(R14/1-20) File Mark "c\-__-40 Prescribed by Department of Local Government Finance INSTRUCTIONS: To be filled in person or by mail. F rm filedwith: 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 0 County Recorder and payable. See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Wesley Dean Fryman and Kelly Lynn Fryman Taxing District �� Key number 26-11-15-101-003.549-027 R cord number Page number 01-/5400 Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is Is the o applicant ablent the er?sole assessment date,current year assessment date,current year date of application g $170,000.00 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 t property in question: Annually Assessed Real Property ❑Annually Assessed ■ TM IC 6-1.1-7) Name of mortgagee or contract seller H� L 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 MAR 31 2022 Name of assignee or other owner or holder of mortgage ��/' Address of assignee(number and street,city,state,and ZIP code) / zr-itQd a. " GIBSON COUNTY AUDITOR Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,uctstate amount of other county on property for dedin Indiana? ❑ Yes No current year? p--Yes 0 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 20 20 20 20 CountyDate(month,day,year) Signatureoun Au itor '31/D / e certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and owner/contract buyer of the aforementioned property on date application is filed. Date(month,day,year) Signature(owner's full name) X V.7v� p � �� 3/2Y(2� ` s of�icant(�r Full resident address applicant(number an street,city,state,and ZIP code) 2568 W Julie Dr., Princeton, IN 47670 Date(month,day,year) Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Address of authorized person(number and street,city,state,and ZIP code) The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.