HomeMy WebLinkAboutMortgage_Goebel (2) ,�.,E fT4Tp STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(Ri 2/6-14) Gibson Johnson 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 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)
David L. Goebel and Cindy L. Goebel
Taxing District Key number/legal description Record number Pa number
024 26-23-16-200-002.498-024/Warrenton Place South Lot 18 a(� tei
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 of application legal or equitable owner?
$219,200.00 El 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
✓❑ 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) ILED
1700 Magnavox Way, Ste 220, Ft Wayne, IN 46804
Name of assignee or other owner or holder of mortgage •
OCT 2 5-2019
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property'n any If yes,what county? What Taxing District? r�t sted If yes,state amount of deduction
rY A
other county d nTOR
in Indiana? ❑Yes No current year? Yes o
A person is not entitled t 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 1 21 20 20 20 20 20
Signature of County AuditorIC\ County Date(mo h,2�y y p
/V'l
II We certify under the penalty of perjury that the above and foregoing information i tr and correct and that the applicant is resid nt of Indiana and
o• -- /contract buyer of the afore entioned property on date application is filed.
i• ature,owner' Ufflemey Date(month,day,year)
)0't(- 11
Full resident address of applicant(nu ber and street,city,state,and ZIP code)
1644 East Autumn Ridge, Haubstadt, IN 47639
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 neriury can include imnrisonment uo to two and a half years and a fine not to exceed$10,000.