HomeMy WebLinkAboutMortgage_Smith (12) "I •t STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
4 , FOR DEDUCTION FROM ASSESSED VALUATION RECEIVED Gibson Johnson 2022
,� __ ✓ State Form 43709(R14/1-20)
Prescribed by Department of Local Government Fina l JUN 0 7 2022 vFile Mark
INSTRUCTIONS: To be filed in person or by mail. Form filed with:
9
Filin Date: Form must be completed and dated in ttfe al ndar 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)
Matthew W.Smith and Sarah J.Smith
Taxing District Key number/legal description Record number Page number Johnson 26-23-11-200-002.170-024/Lot 15 Whispering Winds Sub Sec 3 e)-02-Z- 25- 2--s .
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?
$475,900.00 $329,000.00 i A Yes • Flo
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom l
If name on record is different than that of applicant,indicate below: Is property In question:Annually Assessed 1
FILED eel Property ❑AnnuallyAssessed Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union JUN 0 7 2022
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theatre Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage GI COUNTY AUDITOR
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own prop any If yes,what county? What Taxing District? Has this deductio been requested If yes,state amount of deduction
other county on property for Yes 0 No
in Indiana? ❑Yes o current year?
A person is not entitled this deduction unless the person has a balance on the person's mortgage or con ract indebtedness that is recorded in the county
recorder's office(includi 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 County Date(month,day,year)
c`f1�A ns Gibson 6 .1- 22-
I/We certify under 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 aforementionede \� property on date application Is filed.
Sign re(o a full name) 7:::4 N `V — Dat4,(a rl;/r,day,
C �l/4G/lt/, c.
Full resident address of applicant(number and street,city, e,and ZIP code)
4060 E Valley Pass,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)
The penalties fnr rwri„r,r rows:r+.'r„rl.,f.nr,r:..,r,menr,,.,tr.ti..n end a half years and a fine not to exrow3,4 air..,.,r,