HomeMy WebLinkAboutMortgage_Rembe (2) `, "'-a. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year Year
"` ''s RECEIVED Gibson Pato �S�
x+ '>;; FOR DEDUCTION FROM ASSESSED VALUATION
��-,-; State Form 43709(R14/1-20)
U 2022
• •61 Prescribed by Department of Local Government Finance JUN 0 7 2022 it)File Mark
71 _ ^ 1 Form filed with:
INSTRUCTIONS: To be filed in person or by mail. �(�x.
r
Filing Date: Form bmust be completed and e filed or postmarked withethe County Ad in the uditor County Recorder of the ar for which the deduction tcounty s hwhere the property County Recordero
Must
is located on or before January 5 of the calendar year in which the property taxes are first due and payable. County
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Page number
Larry G.Rembe and Lorri K. Rembe I Record number jro 3
Taxing District pppp Key number/legal description 'yp Z'Z.
Patoka 1�Jp - 126-12-19-400-001.133-027/PT NE SE 19-2-10(2.50 AC)
A Mortgage/Contract
legal r equitablea owner?
sole
le
Assessed value of real roperty as of Mortgage/Contract indebtedness unpaid as of date of application
indebtedness unpaid as of Is the applicant the so e
assessment date,current year assessment date,current year es 0 No
$159,200.00
If no. 0 his I If owned with someone other than spouse,indicate with whom
If no,what is his/her exact share of interest? Il $'i
....—•� P -13
Is a property in question:Annually Assessed
If name on record is different than that of applicant,indicate below: _ # Real Property ❑Annually Assessed
1: mil--e Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller JUN 0 7 2022
Evansville Teachers Federal Credit Union 1
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
O�� uDjyp�
4401 Theatre Drive, Evansville, IN 47715 SON C
Name of assignee or other owner or holder of mortgage G,B
Address of assignee(number and street,city,state,and ZIP code) state amount of deduction
Has this deductio •-en requested If yes,
Ifyes,what county? What Taxing District. on property for
Does applicant own property i•any 0:I Yes 0 No
other county ��' current year? A
in Indiana? 0 Yes No
A
person is not entitled •office this
deduction unless
equity line the person has of credit tha is recolance on the person's yded in the county recorder's office)that is thebasis for the deductiondness that is �ed in the county
recorder'sCOUNTY AUDITOR
Deduction approved in the amount of:
20 20 20
20 20 20
20 Date(month,day,year)
( t eillomIII County 6--')• 1,0 Z'Z
Signature of County Auditor Gibson
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident ofIndiBB a and
owner/contract buyer oft i aforementioned property on date applicatio• I fled- , Date ••nth,, -y.y�)
Full reside t a••ress of ap• cant(number and street,city,state,and ZIP co•111111...
2173 Sg•. E, Princeton, IN 47670 Date(month,day,year)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
The penalties for perjury can include imprisonment up to two and a half vears and a fine not to exceed S1O.000