HomeMy WebLinkAboutMortgage_Taylor dn_„, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS T p I Year
..a _. ' FOR DEDUCTION FROM ASSESSED VALUATION r.i 1' E !s;
State Form 43709(R12/6-14)
Prescribed by Department of Local Government Finance
INSTRUCTIONS: SEP 3.0 2b 16 Math
To be filed in person or by mail. Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is soug be filed or postmarked with the County Auditor or County Recorder of the county where th - County Auditor
located on or before January 5 of the immediately succeeding calendar year. nn�nunty Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the CountyQIBrSO OUGGUN)TY AUDTTUK.
where the property is located during the twelve 02)months before March 31 of each year the deduction is sought
See reverse side for additional instructions and qualifications. . -
Applicant(owner or contract buyer-see resuiaions on reverse side)
Tyler R and Megan L. Taylor
Taxing District Key number/legal description Record number Page number
Gibson 26-17-01-200-003.952-021, Pt. W Half NE Quarter 1-3-12 3.48 Ac x0129 Hit 7
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,anent year March 1,cu gent year date of application legal or equitable owner?
x100 qgs ❑ Yes ❑ 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 du°terent than that of applicant indicate below Is the props try in question:Annually Assessed
12 Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee Of contract seller
Ruoff Mortgage Company, Inc dba Ruoff Home Mortgage
Address of mortgagee or contact seller(number and street,city state.and ZIP code)
1110 E Dupont Road Fort Wayne, IN 46825
Name of assignee or other owner or holder of mortgage - .
Address of assignee(number and street,city sate.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 on property for 300.00
in Indiana? ❑Yes ❑No current year? 0 Yes ❑No
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 20 20
Signature of County Auditor County Date(month,day,year)
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
nor/contract buyer of the aforementioned property on date application is filed.
igna;ure ow name) Date(mptrth� ay year)
Full r stl nt addre of a licant(number and sweet,city,stare,and ZIP code)
48 South 0 West Owensville, IN 47665
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$10,000.