HomeMy WebLinkAboutMortgage_Bainbridge III 41-- .„ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
10 A It FOR DEDUCTION FROM ASSESSED VALUATION RECEIVED Gibson ` 2022
State Form 43709(R14/1-20) L—
Prescribed by Department of Local Government Finance
1 JUN 0 7 2022 File Mark
INSTRUCTIONS: To be filed in person or by mail. 1 \ \ � Form filed with:
Filing Date: Form must be completed and dated in the caleyear for which the deduction is sought. ( ji I County Auditor
Must be filed or postmarked with the County Au or or County Recorder of the county where the propert
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)
Richard Bainbridge, III
Taxing District r Key number/legal description Record rd number Page n rnttry ,
Ba ! 26-20-14-301-000.021-002/Pt NW SW 14-3-9(0.31 A)
sessed 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 leg I or uitable owner?
$67,100.00 $193,431.00 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: t property in question:Annually Assessed
Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller F I L E
Evansville Teachers Federal Credit Union
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 JUN 07 2022r d
Address of assignee(number and street,city,state,and ZIP code) V) Q- .�/'Y��+'
e�¢(1M CoUN-ry AUDITOR
Does applicant own props in any If yes,what county? What Taxing District? G 'P1'ds this3educti000���,,,��}b,,,///qqqeee n requested If yes,state amount of deduction
other county on property for es 0 No
in Indiana? ❑YesNo current year? b✓7ei\Ya'
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or c n 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)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(mo th,day,year)
� Y1.. (J� Gibson 6 � ^vo?.Z
I I We certify under penalty of perjury that the above and foregoing Information Is true and correct and that the applicant Is a re Ids� t of Indiana and
owner/contract buyer of the aforementioned property on date application is flied.Si (own s full name Date(month,day,year)zo ZZ_
Full resident address of applicant(number and street,crtylstate,and ZIP code)
9559 E Main Street, Mackey, IN 47654
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)
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