HomeMy WebLinkAboutMortgage_Stodghill (2) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS u T w s �. Year
� � FOR DEDUCTION FROM ASSESSED VALUATION ��gryq{ t f
r State Form 43709(R13/10-15) r4-11 - •r 2018
Prescribed by Department of Local Government Finance 1�
INSTRUCTIONS: OCT 11DIeNi Ianfk
To be filed in person or by mail. Form feed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the pro. ! 's y II County Auditor
located on or before January 5 of the immediately succeeding calendar year u ((��n� UN r( T)k°i.'t1 "recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Audl tftt'cobhly
where the property is located during the twelve(12)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 restrictions on reverse side)
Andrea L. Stodghill
Taxing District Key number/legal description d` d number Paga r►ttnper�
Ft. Branch _ 26-18-13-404-000.542.026 iT 41 N/VI
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,=rent year assessment date,current year date of application legal or equitable owner?
52,900 106,040 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 dtterent than that of applicant,indicate below: Is the property in question:Annually Assessed
TA Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Ruoff Mortgage Company, Inc.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
1110 E. Dupont Rd. Fort Wayne, IN 46825
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property irlfany If yes,what county? Mat Taxing Dismct? Has this deduction been requested If yes,state amount of deduction
other county ,—, I.4,, on property for
in Indiana? year?No current yea Yes El 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
owner/ tract buyer of the ate entioned properly on date application is filed.
Signatu s •e /_ Date/(month,day,year)
Full resident address of applicant(number and save ci state,and ZIP code)
107 East Walnut Ft. Branch, IN 47648
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.