HomeMy WebLinkAboutMortgage_Kolb (5) e
-'':":',',a. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION Gibson 0 Z 2022
� State Form 43709(R14/1-20)
% %e 9 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. 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. County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Jennifer Leigh Kolb and Brandt David Kolb
Taxing District Key number/legal description Record number P e number
26-19-18-101-001.015-026/LITTLE YORK VILLAGE 7-0 2 2
Fort Branch 36PT/37 PHASE 1
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is he applicant
le
assessment date,current year assessment date,current year date of application eg equitable owner?
$0.00 $309,000.00 tomes 0 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: Is th perry in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name mortgagee contract seller
First FILED
Federal Savings Bank
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
5001 Davis Lant Drive,Evansville, IN 47715
Name of assignee or other owner or holder of mortgage S E P 0 8 2022
Address of assignee(number and street,city,state,and ZIP code) t� /�
_ .✓,//(� amount of deduction
Does applicant own properly in any If yes,what county? What Taxing District? Has this dedu - r^"NTY A DIT
other county on property for r .eS O
in Indiana? 0 Yes ❑ No current year?
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or, on =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)the is the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of Co AtyA County mci j81
Gibson -Z
1/We certify under penalty of perjury that the above and fo egoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on d applicatio "s filed. ,( Ar pp iy/Signa owners full na ) "\___ j.,„ /'/ X �I D /
Fu resident address of applicant(number and street,city,state,and ZIP cod
902 Chickasaw Dr., Fort Branch, IN 47648 Date(month,day,year)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
Address of authorized person(number and street,city,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to s,v.bes,."n n^"