HomeMy WebLinkAboutMortgage_Michels (2) _._.... .__......_.-_.
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�t"gt FOR DEDUCTION FROM ASSESSED VALUATION O`�
�! i j State Form 43709(R14/1-20) RECEIVEDGibson 1 2022
Prescribed by Department of Local Government Finance I
( kf te_ ,_'N�, .2- - OCT 1 1 2022 Ale 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 erestnctibris verse side)
KALE D.MICHELS ,
Taxing Districy� 1- 7' Key number/legal description Recordnumber P r�ylytber
J\ 26-06-06-100-703.740-017 7? ^f1_��-\1
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 equj le owner?
12,000.00 IiiiYes El 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' is the partyroper in question:AnnuallyAnnuallyAssessed Assessed
ty ❑
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller F ILF� �✓ eal P
Evansville Teachers Federal Credit Union eOCT 1 4 2022
Address of mortgagee or contract seller(number and street,city,state.and ZIP cod
P.O.Box 5129,Evansville,IN 47716-5129
Name of assignee or other owner or holder of mortgage V'1.. 1 &.
GIBSON COUNTY AUDIT°
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in y If yes,what county? What Taxing District? Has this deduct' n req If yes,state amount of deduction
other county on property for
in Indiana? ❑Yes No current year? Yes i.- o
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or act ind-.tedness 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 \ Dat�( o th.'da yeah - Z
V-A ,, .
I/We certify under the penalty of perjury that the above and foregoing information is tru�nd correct and that the applicant i a res ent of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
A � Date(month,day,year)
Signae(ow r'slull ��/r/ r/�
r�-,t //jV(�/`r ..../.. January 25,2022
r['(�'•, 'dent address of applicant(number and street,city,state,and ZIP code) �/
5(04 3 E -15 U lS N A Z L ETO t , 1 NI 4"U '- v
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
January 25,2022
Address of authorized person (number and street,city,state,and ZIP code)
4 The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.
oa
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RECEIPT FOR FILING STATELD O `•R CONTRACT INDEBTEDNESS
Name of applicant r
. o• lay =•ee or contract seller
O a)KALE D.MICHELS 1 0 rTl
xmount of indebtedness Taxing District Q��
Date Clfil month,day,year) n
�c� - \1�=�� L OCT1ml�022
^ r-.a <
Key number/legal description �`J ZL-g '7 N v
•
r 26-06-06-100-703.740-017 %`/ Ql� =6ouelly Date month day,year) ^�
Signature of Coun Auditor//County R_ er 7)) GIBSON COUNT', NU S4� `��l�" ` L
Wl (\ J