HomeMy WebLinkAboutMortgage_Piper ";"" a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
1 FOR DEDUCTION FROM ASSESSED VALUATION Gibson toka 2022
o ,;; ' State Form 43709(R14/1-20) RECEIVED p��
a Prescribed by Department of Local Government Finance
JUL 2 7 2022 File Mark
INSTRUCTIONS: To be filed in person or by mail. J -O � ormfiled with:
Filing Date: Form must be completed and dated in the calen 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. ounty Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
James S Piper and Seean T Piper ?J�
Taxing Dist ct Key number/legal description IDco�nri er ` .7-Iuu
Patoka 26-11-15-202-004.772-027/Lt 21 White Church Crossing �fU\LJ L }l�yTl)�
Assessed value of real pr erty 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�o fquitable owner?
$18,900.00 $265,555.00 Yes ❑ No
If no,what is his/her exact share of interest? I If owned with someone other than spouse,indicate with whom /
If name on record is different than that of applicant,indicate below: Is a property in question:Annually Assessed
FILED Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Old National Bank, ISAOA/ATIMA
Address of mortgagee or contract seller(number and street,city,state,and zipAjt 2 7 Z022
PO Box 918,Evansville, IN 47706
Name of assignee or other owner or holder of mortgage tth,cit.zei /y Au,-. )
Address of assignee(number and street,city,state,and ZIP code) GIBbOPt COUNTY AUDITOR
Does applicant own property any If yes,what county? What Taxing District? Has this deducti en requested If yes,state amount of deduction
other county ❑YesrNo
on propertyfor El No
in Indiana. current year?
A person is not entitled this deduction unless the person has a balance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(includin 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 M`W �'!a <, County Dat (moot day,year)
Gibson -vi-- -z--
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant is a residen of Indiana and
owner/contract buyer of the aforementioned property on date app" ation Is filed.
Signature(owner'name) � Date(rr/Z_ 4,year)
Full resident al,s of applicant(n m and street,city,state,and ZIP code)
t '7/ (�-
765 Cathy .rive, Princeton, I 47670
Person authorized by duly executed Power of Attomey or by IC 6-1.1-12-0.7 I Date(month,day,year)
Address of authorized person(number and street,city,state,and ZIP code)