HomeMy WebLinkAboutMortgage_Schafer (4) 4- STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
d ° FOR DEDUCTION FROM ASSESSED VALUATION
•o;el State Form 43709(R12/6-14) Gibson Union 2020
• 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 ❑✓ 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)
Detrix A. Schafer and Hannah R. Schafer
Taxing District Key number/legal description Record number Page number
a�025 26-19-09-200-002.388-025/Pfohl Minor Subdivision Lot 1, Gibson County 1� 3u lc<
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contact indebtedness unpaid as of Is the applicant the sole
March 1,anent year March 1,current year date of application legal or equitable owner?
$200000.00 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 applicant,indicate below: Is the property in question:Annually Assessed
F I R Annually Assessed
6
Mobile Home(IC -1.1-7)
Name of mortgagee or contract seller I i
Ruoff Mortgage Company, Inc.
Address of mortgagee or comract seller(number and weer,city,state,and ZIP code) S E P 1 0 2019
1700 Magnavox Way, Suite 220, Fort Wayne, IN 46804
Name of assignee or other owner or holder of mortgage iiiiP^
Address of assignee(number and street,city,state,and ZIP code) G I B SO N COUNTY AUDITOR
Does applicant own propertany If yes,what county? Vvhat 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 ❑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 amo 1r6 &:
•
20 2 20 20 20 20 20
Signature of County Auditor ", c 1 County Date(rp th 1daytiye o
II We certify under the pertcdti o perjury that th abovl`-,'V1 regoing information is true and correct and that the applicant tii�sba reside t of Indianadii and
owner/contract buyer of the aforementioned pr perty on date application is filed.
i attire(ow /s fullna7re4 Date(month,day year)
A WTJa_ 8/22/2019
I r ident address o ap nt(nu stree.c ZIP code)
250 East 600 South, rt Branc , IN 47648
Person authorized by duly executed Power of Atomey 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.