HomeMy WebLinkAboutMortgage_Allen (17) k-4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
a N\ FOR DEDUCTION FROM ASSESSED VALUATION Gibson Johnson 2023
5' State Form 43709(R14/1-20) RECEIVED
•'• =, Prescribed by Department of Local Gov nment Finance
INSTRUCTIONS:To be filed in person or by mail. 1(J-Mn0Iq I MAY 3 1 2022 File Mark
Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. 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. ❑ County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Anthony Allen
Taxing District Key number/legal description Record number Page number
024 26-19-32-100-002.608-024/PT W NW 32 3 10 1.00 AC D-9,Gibson County aO Q3t.5-
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?
198,000.00 ® Yes ❑ No
If no,what is his/her exact share of interest? If ownedne with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: 1 L E D Is the property in question:Annually Assessed
IX Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller MAY 3.1 2022
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
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4401 Theater Drive,Evansville,IN 47715 OID;ON COUNTY AUnITOR
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 deducti b requested If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes slA No current year? Yes ❑No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or ont 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)the 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 County Date onth, ay,year)
I/We certify under the penalty of perjury that the ab a and foregoing information is t and correct and that the applica t is resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
S. ature(owner's full name) Date(month,day,year)
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Full resident addre applicant(number and street,city,state,and ZIP code)
9672 U.S.Highway 41,Haubstadt,IN 47639
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)