HomeMy WebLinkAboutMortgage_Marvell (3) a•^^.11 •% STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year4.4
FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R12/6-14) 1�� 1, fg� o Washington 2020
Prescribed by Department of Local Government Finance (�"1 p
INSTRUCTIONS: 11 g File Mark
To be filed in person or by mail. �e11�I� qq qq g019 Form filed with:
Filing Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deductwo&s41rg11L
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. El County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the Countyy)udito unty
where the property is located during the twelve(12)months before March 31 of each ye IS?VtOR
See reverse side for additional instructions and qualifications. GIBSON COUNTY A
Applicant(owner or contract buyer-see restrictions on reverse side)
Michael F. Marvell
TaAng District Key number/legal description Record number uelbeS
017 26-06-19-300-000.657-017/ Kirksville 1 PT/2/3/4/5 22�f/y QI
Assessed value of real property as of Mortgage I 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?
$80,091.00 p 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 app5cant,indicate below'. Is the property in question:Annually Assessed
❑v 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
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 ny 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? ❑El Yes ❑No
A person is not entitled to his 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 I contract buyer of the aforementioned property on date application is filed.
ighature full
na"°" ) /� 4 t _ _ Date(month.day,year)
7/30/2019
Full resident address of applicant(number and street,city,state,and ZIP code)
5853 East 390 North, Francisco, IN 47649
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.