HomeMy WebLinkAboutMortgage_Mapes e% STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
-M FOR DEDUCTION FROM ASSESSED VALUATION (l 1 1n s�
"tit. State Form a3709(Rf3/10.t5) 1 • 1 It)- ` a�oi9
Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
To be filed in person or by mail. F m fi ed 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 property is County Auditor
located on or before January 5 of the immediately succeeding calendar year County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county
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)
Cord M Mapes and Cheyenne B Mapes
Taxing District Key number/legal description Record numpsr Page number
Union 26-18-24-300-000.091-025 QO I /- 1.39?
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.anent year assessment date,current year date of application legal or itable owner?
149,865.00 Yes ❑ No
If no.what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
II name on record is different than that of applicant,indicate below: I •- property in question:Annually Assessed
!Z Real Proper ■ • malty Assessed
-rpm "bile Home(IC 6-1.1-7)
Name of mortgagee or contract seller 1 ' 11
Ruoff Mortgage Company, Inc. ISAOA '1
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)
.?ay Ste m ,,,Were...YC APR 2019
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) ngacer
G1t3g0' li N COUNTY
No AUDITOR
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
in Indiana? ❑Yes ❑No current year? ❑Yes ❑
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 fine 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
Signet a of County Auditor County Date(month.day,year)
San C LI --18—ICI
I/We certify under the penalty of perjury at the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Signa,(,o/rr' et'srfull n me)
f��j Date(month.day,year)
•
Full resident address of app„cam,(humber and street,city state.and ZIP code)
1185 W 800 S, Fort 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 penury can include imprisonment up to two and a half years and a fine not to exceed$10,000.