HomeMy WebLinkAboutMortgage_Johnson (43) 7` ""4. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township" Year
- FOR DEDUCTION FROM ASSESSED VALUATION
q , State Form 43709(R14/1-20) RECEIVED Gibson 0 P.- 2022
Prescribed by Department of Local Gove .. ent Finance
File Mark
INSTRUCTIONS: To be filed in person or by mail. 1101♦ APR 2 5 2022
J Form filed with:
Filing Date: Form must be completed and dated in the calendar year r which the deduction is sought. Q 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 taxes are 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) I I S CI 0 (�
Michael W.Johnson and Latisha K.Johnson
Taxing District ( y number/legal description Record number Page number
W1'"Z'S)11 26-0 0-46 002 003.042-017 nd LOC2 11 77)JdazJeterr PT LOC 2 1 10.67 AC
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 o equitable owner?
$0.00 $90,000.00 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 a property in question:Annually Assessed
FILED Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union Address of mortgagee or contract seller(number and street,city,state,and ZIP code) APR 2;6 2022
4401 Theater Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage !.j•I_ ,
�(<G/tat a. AUDITORiiii-t
Address of assignee(number and street,city,state,and ZIP code) GIBCON COUNTY
Does applicant own property' any If yes,what county? What Taxing District? Has this deductio en requested If yes,state amount of deduction
other county ❑ on property for
in Indiana? Yes No
current year? Yes 0 No
A person is not entitle this duction unless the person has a balance on the person's mortgage or c n ct 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 CrIU S County Gibson Date onth day,year)
tt 21Cy
I I We certify under penalty of perjury that the abo d foregoing information is true and correct and that the applicant is a re dent f Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
' atu (owner' 4,( h,dey ear)
Full resident address of applica t(num r and street,city,state,and ZIP code)
10900 N.Salem Ln., Hazleton, IN 47640
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)