HomeMy WebLinkAboutMortgage_Johnson (44) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
1,1 FOR DEDUCTION FROM ASSESSED VALUATION Gibson O��- 2022
��, State Form 43709(R14/1-20) RECEIVED
Prescribed by Department of Local Gove ent Finance
Jlf�[ 1C APR 5 2022 File Mark
INSTRUCTIONS: To be filed in person or by mail. ,e
2 Form filed with:
Filing Date: Form must be completed and dated in the calendar year or which the deduction is sought. Lr 1 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. �U
Applicant(owner or contract buyer-see restrictions on reverse side) t
Michael W.Johnson and Latisha K.Johnson
Taxing District
^6-02-47-002-004.017-017/ T LOC 2--)- 177)
fin. 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 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 e property in question:Annually Assessed
IIIILEDReal Property ElAnnually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union ) APR 2;6 2022
Address of mortgagee or contract seller(number and street,city,state,and ZIP code
4401 Theater Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage Yh ' '►a)
Address of assignee(number and street,city,state,and ZIP code)
GIBSONC a.y,f!/ s AUDITOR
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 Yes 0 No
in Indiana? ❑Yes NO current year? b
A person is not entitle this duction unless the person has a balance on the person's mortgage or c n act 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 r() v1 / County Da ont(O Gh a__�`��
y.year)
fir( Gibson 2 �
I,We certify under penalty of perjury that the abo d foregoing information is true and correct and that the applicant is a re ident Indiana and
owner/contract buyer of the aforementioned property on date application is filed. a(mo th,day ear)
• a (owner' -,\-
Fu I resident address of applica t(num r and street,city,state,and ZIP code)
10900 N.Salem Ln., Hazleton, IN 47640 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)
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