HomeMy WebLinkAboutMortgage_Lindsey a ".a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
E__ FOR DEDUCTION FROM ASSESSED VALUATION
Sate Form 43709(R12/6-14) Gibson Patoka 2020
c-,,_.- Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
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 sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is ❑J 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 CountyAuditor 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)
Shannon M. Lindsey
Taxing District Key number/legal description Reco um r Page number
028 26-12-08-103-001.059-028/S & R Add pt Lot 24, Gibson County -,iQ4.0
Aawssed 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 of application legal or equitable owner?
$89393.00 p Yes ❑ No
If no,what is his/her exact share of interest? If awned 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
2 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)
1700 Magnavox Way, Ste 220, Ft Wayne, IN 46804 a, % { F:..: ? r!-
Narne of assignee or other owner or hdder of mortgage `- .--^• t---r
Address of assignee(number and street,city,state,and ZIP code) AUG 6 c 2019
Does applicant own property in any If yes,what county? What Taxing District? Has this deduction•--n requested yes,state amount of deduction
other county on property for r i _ 2
in Indiana? ❑Yes !❑No current year? Ct• wail'R7jy
A person is not entitled to this deduction unless the person has a balance on the person's mortght3V4rgrel' = iiikatatlifqtRylltentiecorded 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 Counrypi:o ; ,y r-� z County Date(month,day,yeah
I/We certify under
''the penalty of perjurythat 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.
J. Signet e(owner's full name) Date(month,day,year)
7/12/2019
Full resident address o i t(number and street a nd ZIP code)
- 219 North Reavis Street, P on, 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 S10,000.