HomeMy WebLinkAboutMortgage_Masterson STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
a • FOR DEDUCTION FROM ASSESSED VALUATION ���
Sate Forth 43709(R12/6-14) 26 02 2020
Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
To be filed in person or by mail. MAR p LU y�llIJY4
t:
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 property is ❑ County Auditor
located on or before January 5 of the immediately succeeding calendar year. C order
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the coup
where the property is located during the hvekre(12)months before March 31 of each year the deductiprljflg U COUNTY AUDITOR
See reverse side for additional instructions and qualifications. li tl
Applicant(owner or contract buyer-see restrictions on reverse side)
Matthew W. and Jessica Masterson
Taxing District Key number/legal description Record number Page nu ber
021 26-17-03-300-001.123-021/ Pt SW 3-3-12 2 AC, Gibson County 401 it
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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,current year March 1,current year date,qf app'cation legal or equitable owner?
( ) 0 ❑ 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 different than that of applicant,indicate below: Is the property in question:Annually Assessed
0 Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Ruoff Mortgage
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
1700 Magnavox Way Ste. 220 Fort Wayne, IN 46804
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 in any If yes,what county? What Taxing District? Has this deduction been requested If yes,sate amount of deduction
other county ,-t(� on property for
in Indiana? ❑Yes No current year? ❑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 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 I contract buyer of the aforementioned property on date application is filed.
)g t (own yes full� name) Date(month,day,year)T.t 67,14 1V. i(�l a� 1 e�.1� �8 r �l 2/28/2019
Full resident address of applicant(number and street,city state,and ZIP code)
5356 South 950 West, Owensville, IN 47665
Person authorized by duly executed Power of Attorney or by IC 61.1-12-0.7 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.