HomeMy WebLinkAboutMortgage_Partridge (2) ?*►,a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
't FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R14/1-20) iy.b as 2022
Prescribed by Department of Local Government Finance File Mark
INSTRUCTIONS:
To be filled in person or by mail. Fo f d with:
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
property is located on or before January 5 of the calendar year in which the property taxes ae first due County Auditor
and payable. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Lisa Partridge and Matthew Partridge
Taxing District Key number/legal description 26-19-18-400-002.474-025/7440 S Sunrise Record number Page number
Dr. Fort Branch, Indiana 47648
Og 26-19-18-400-002.474-025 22- AL492�
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�ui-rtable owner?
$328,000.00 1=1 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 th�e perty in question: Annually Assessed
Ll'Real Property El Annually Assessed
Name of mortgagee or contract seller FILEnome
(IC 6-1.1-7)
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 MAY 2 7 2022
Name of assignee or other owner or holder of mortgage /J .L 1
Address of assignee(number and street,city,state,and ZIP code) The -e &.L4LL�vnai
GIBSON COUNTY AUDITOR
Does applicant own property in any es,what county? What Taxing District? Has this deduction been requested If yes,state amount of
other county on property for deduction
n Indiana? 0 Yes l� current year? 0 Yes +DiIVo
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 Audit r ounty Date(month,day,year)
J b5a � /���v��
I/We certif n r he 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.
Signature(owner's fullDate(month,dgx year) -. --
Full resident address of applicant(number and st city,state,and ZIP code)
7440 S Sunrise Dr., Fort 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) FILED
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.