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HomeMy WebLinkAboutMortgage_Gooch (3) `"0•7"'' ° - � STATEMENT OF • FOR DEDUCTION OR CO } NOM i state Form ED CTIONi FROM ASSESSEDCONTRACT INDEBTEDNESS�'a VALUATION County Prescribed by Department of Local ry Township Government Finance Gibson INSTRUCTIONS. To be filed in person or by 2022 Filing Date: Form Y mail. must be completed and dated in the calendar Must be fled or ile Mark is located postmarked with the Countyyear for which theo der of the is sou on or before January 5 of the calendar Auditor or CountyFor• filed with: propert See reverse side for additional instructions and•ua/ifiications. Recorder of the sought year in which the property taxes are firstue payable. County Auditor Applicant(owner or contract buyerthe Blaine M Gooch see restrictions on reverse side) and Payable. Taxing District and Jaclyn Nicole Gooch ........ County Recorder P_ • a �� Key number/legal description Assessed value of real , 2eynumber20gal des assessment date, Property as of n O8-bu8/N 1/2 Lt 97 R ord current year Mortgage/Contract indebtednessoriginal plan number Assessed value assessment date,curt unpaid as of 2Z Page the of er current year Mortgage/Contract indebtedness /b If no,what is his/her exact share date of unpaid as of of interest? application Is the applicant the $143, $236,eo n.other le•al or sole If name on record isequitable owner? different than that of a eill omeone other than applicant,indicate below - spouse,indicate with whom _Sro es 0 No Name of mortgageeorIs the property in question:Annual)Evansville Teachers contract ct seller UN 2 9 2022 �1 Annually Assessed eat Property ❑An Address of Federal Credit Union Annually Assessed mortgagee or contract seller4 Mobile7 • 4401 Theatre Drive, le(number and street,city, Home(IC 6- ) Name of assignee or other owner orrho der of mortgage y St. e Ar,7:►,. / _• , GIBBON �jNTY AUDITOR Address of assignee(number and street,city,state,and ZIP code) Does applicant own other county property in an in Indiana? ❑Yes any If yes,what county? NO What Taxing District? A person is not entitled ' Has this deductio be recorder's office o this deduction un/ess the on property requested If yes,state amount of deduction current yearor IN ❑NO (including any home equity fine of credit thatas recorded in on the recorder's office)that the person's mortgage or••nt ,ct indebtedness that is recorded in the county COUNTY AUDITOR Deduction approved in the amount of: basis for the deduction. 20 20 _ Signature of 20 County Autlitorrn` _r� 20_ 1 ' 1�1V� �� VLI �� 20 20 1 f We certify County 20_em fy under penalty of perjuryGibson owner/contract buyer of the aforementioned d foregoingte is fit is true and correct and that the a Dom( that the a��r (�O !��,,}77_RR�JJ���rr Signature W e(owner's full ram property �? , ' P Petty on date application is filed. �� �\ � applicant is a re(- Full esident addressV V .�.. C'�\ ent o Indiana and of applicantaW 428 N (numbern, 767stree amity,state,and ZIP code) Gibson Street, Princeton, IN 47670 Date(-onth'erson authorized byYear) duly executed Power of Attorney or byIC 6- ,1.1-12-0.7 Date(month,day,year) ,ddress of authorized person(number and street,city,state,and ZIP code)