HomeMy WebLinkAboutMortgage_Ferrell /,,:a^ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
t�„ Gson 027 2022
� State Form 43709(R14/1-20)
4,
-i- ./ Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS: To be filed in person or by mail. Form filed with:
Filing Date: Form must be completed and dated in the calendar year for which the deduction is sought. Q County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is El County Recorder
located on or before January 5 of the calendar year in which the property taxes are first due and payable.
See reverse side for additional instructions and qualifications.
I Applicant(owner or contract buyer-see restrictions on reverse side)
Kevin Ferrell
Taxing District Key number/legal description Record number Page number
027 26-12-05-400-700.624-027 -2-42 2 313 Z .
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?
103,500 RIYes ❑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: F i E r� Is the property in question:Annually Assessed
"1 j.-// 0 Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
AUG 2 9 2022
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
l
Fairway Independent Mortgage
Name of assignee or other owner or holder of mortgage GIBSON COUNTY AUDITOR
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction been requested If yes,state amount of deduction
other county ❑ ❑No on property for 0 Yes ❑No
in Indiana? Yes current year?
A person is not entitled to 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(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 r, ,',,,'%1:
ofotioue of-County Auditor V �S_ � County
Gson Date(� th,2 da(1 year) ZZ
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I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applica i a res dent of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Date(month,day,year)
Signature owners full name)
ir-- -7' " It 8/23/Zb2Z
Full resident address of applicant(number and street,city,state,and Zll KEVIN E FERRELL
1435 E Conservation Dr, P'ton,IN 47670 JODI R FERRELL
Person authorized by duly executed Power of Attorney or by IC 6-1.1-1: 6671 BRIAR CT Date(month,day,year)
EVANSVILLE IN 4771 1-1 605
Address of authorized person (number and street,city,state,and ZIP r
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.
RECEIPT FOR FirrEar RTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Name of mortgagee or contract seller
Kevin Ferrell Fairway Independent Mortgage
Date filed(month,day,ye Amount of indebtedness Taxing District n
at
'),02 2" AUG 2 9 2022103,500 0 L
Key number/legal descriptionrl 3 12'Z
26-12-05-400-700.624-027 ♦ C- tJ
�� ii �� .,.Lnty Date(moot day,Tar)
Signature of County Auditor/County Recorder • t'ky 1,0 z2_
DlraGson ((��