HomeMy WebLinkAboutMortgage_Neufelder (6) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R14/1-20) Gson 026 2022
Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be riled in person or by mail. Forth filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. 10 County Auditor
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 faxes are first due and payable. ❑ County Recorder
•
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Neufelder, Darwin G/Carolyn L
Taxing District Key number/legal description Record number Page number
026 26-18-13-403-000.561-026 2019 3421
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?
80,000 BYes ❑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: ILED Is the property in question:Annually Assessed
0 Real Property ❑Mobile Annually
Home(IC 6-1.1-7)
Name of mortgagee or contract seller
ETFCU APR 13 2022
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) yqY���,� �,
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Name of assignee or other owner or holder of mortgage GI- B$ON COUNTY AUDITOR
TOR
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county Oyes on Property(Or No
in Indiana? No current year? Yes ❑
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
Signature of County Audits Date da,year)
fYl� n--s ICourady .S o 1 . �1 �' �22-
I/We certify under the penalty of perjury that the a nd foregoing information is_ and correct and that the applicant a ident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sig re(owner's full name) Date(month,day,year)
14/4.-(ew 05//2/Z0z01...2..
Full resident address of applicant(number a street city,state,and ZIP code)
205 S West ST, Ft Branch, IN 47648
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)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name of mortgagee or contract seller
Neufelder, Darwin G/Carolyn L ET T j )rid
Date filed(month,day yea Amount of indebtedness
. 13 _ L VI- 80,000
Key number/legal description - 2 1
26-18-13-403-000.561-026 APR 1 3 2022 2° l I
Signature of County Auditor/County Record County Date(month,day,,ar)22
co. ilfertZ4vr3a)
GIBSON COUNTY AUDITOR