HomeMy WebLinkAboutMortgage_McEllhiney (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS lounty I Township I Year
' FOR DEDUCTION FROM ASSESSED VALUATION J�� 02� 2022
File Mark
111
r-�t State Form 43709(R14/1-20)
,
Prescribed by Department of Local Government Finance
e
INSTRUCTIONS: Form filed with:
To be filled in person or by mail. ❑
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)
Misty D.McEllhiney IRe rd nu_ ber
mber Page number
Taxing District Key number/legal description 26-12-07-402-002.180-028/806 E Evans St. SQ�
(Princeton, Indiana 47670 ;�( J
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of assessmentIs Its thl e a pllivant the sole
assessment date,current year date,current year date of application$60,000.00 II Yes El No
If no,what is his/her exact share of interest? 'If owned with someone other than spouse,indicate with whom
applicant,indicate below: Is the property in question: Annually Assessed
If name on record is different than that of tEl 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)
Name Theater Drive,o Evansville,or N 47715f PIL
Name of assignee or other owner or holder of mortgage
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 bt�/4fegtogpted If es,state amount of
on prope fo VV s.1
other county current Yes
in Indiana? 0 Yes 0 No
QfP lGa nd�te 1n.i ssstthat is recorded in the county
A person is not entitled to this deduction unless the person has a balance on the person's mortgage o '"'�.�_'deduction.
recorder's office(including any home equity line of credit that is recorded in the county
Y AUDITOR recorder's office)that I -.loot;'gal
0
CO
Deduction approved in the amount of:
I20 I 20 I 20 I 20 I 20
20 20 Signature of County Audit r "`tom County c . (Date(month,day,year)
` ` ,.� .. �. -
I/Vtle certify under the penalty of perjury that a 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,da/y,year)
Signature(owner's full name) 5-1Z l 3 J ZpZ'L
Full resident addfess of alicant(number and street,city,state,and ZIPe)
806 E Evans St.,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 nenalties for perjury can include imprisonment uo to two and a half years and a fine not to eves Tin nnn