HomeMy WebLinkAboutMortgage_Owen (3) Air.t9. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
I " FOR DEDUCTION FROM ASSESSED VALUATION
� 2022
State Form 43709(R14/1-20 RECEIVED Gibson Patoka I,1
',,P-` Prescribed by Department of Local Government Finance
�uo 1 NOV 0 9 2022 File Mark
INSTRUCTIONS: To be filed in person or by mail. �O" CiLt J Form filed with:
Filing Date: Form must be completed and dated in the cate'*i r year for which the deduction is sought. 0 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. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Amanda P.Owen and Randall D.Owen
Taxing Distris\ Key number/legal description Record number Prie
pn
Patoka 1W5 ape 26-12-05-400-000.286-027/Pt SW SE 5-2-10(1.85 A) �'OZZ . —[
Assessed value of real pr rty 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 eqL2.5able owner?
$104,900.00 $213,000.00 es 0 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: FILED Is the l nPropey in question:Annually Annually Assessed
Rearty ❑ Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller 1 20��
Liberty Federal Credit Union NOV1
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
4401 Theatre Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage / t.al.t€ a.
GIBSON COUNTY AUDITOR
Address of assignee(number and street,city,state,and ZIP code)
Does applicant,o,v_�,/ryYes 0 No /p roperty in any If yes, e what county? What Taxing District? Has this deduction b requested If yes,state amount of deduction
other county I.N1 on property for
eS 0 No
in Indiana? 9t ao o ot\Q tn,� current year? W
A person is not entitled to this deduction unless the person has a balance on1 the pers '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 20 20
Signature of County Audito ` `� ("', County Dateronrt,day,year)
w '� —S Gibson t t �!/0 L`�
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant Is a r e of Indiana and
owner/contract buyer of the aforementioned property on date application is flied.
Sign 're cur { f/7. , a wg , - /fir _ , Date/( th,d y,yearj-r
00
Full resident address of applicant(number and street,city,state,and ZIP code) `C�A/ Z �(
1234 E Taftown Road, Princeton, IN 47670
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
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 exceed 510,000.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant Order No. Name of mortgagee or contract seller
Amanda P.Owen and Randall D.Owen 22-2050 F
Liberty Federal Credit Union
Date filed(month,day,year) Amount of indebtedness T T xing District
k\. kO' 2Z $213,000.00 1 j ,d F atoka Regional Title Services
Key number/legal description —7 !")Z2 —L\133 X
26-12-05-400-000.286-027/Pt SW SE 5-2-10(1 ) }/ C/" 1 O23
Signature of County Auditor/County R er CotlFff}'• 1 1 2022 Date(moopt .,daYyy�ear rn
Gibson %) • k V ' �" Z o n
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DI i GIBSON COUNTY AUD m
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