HomeMy WebLinkAboutMortgage_Koch .0,---p STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
°�' 72*-1. FOR DEDUCTION FROM ASSESSED VALUATION County Township Year
J. State Form 43709(R12/6-14) Gibson Barton 2020
`J Prescribed by Department of Local Governmen ' ance
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INSTRUCTIONS: Ita / File Mark
To be filed in person or by mail. ` "l� \
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)
Joseph Anthony Koch
Taxing District Key number/legal description Record Amber Page number
001 26-20-28-100-000.614-001/Pt W 28-3-9 1.13 AC D-19 a 040000 o 0 9s g
Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the 6ile
March 1,current year March 1,current year date of application legal or equitable owner?
$227,000.00 0 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)
1700 Magnavox Way, Ste 200, 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 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 Ill No current year? ❑Yes ❑No
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 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 flp 20 0 20 20 20 20
Signature of Counror `ir\ County Date(month,day,year)
L
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the a.plicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
--›gn re(owner ull name) ae( h;d yearFiLLtmontj20
ull resident address of applicant(numbe and street,city,state,and ZIP code)
8921 South State Road 57, Elberfeld, IN 47613 MAR 0.5 2020
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Nam • ,:41 ft
Address of authorized person (number and street,city,state,and ZIP code) GIBSON COUNTY AUDITOR
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
NamJoge9)1
otlapplicant Na of mort gee or contract seller
}Cock KID
Date filed(monft,4 day,year Amount of in bled ess T g Di tr' t ,
Key number/legal description,
- fib- &o® .c-Q(4. co (
Signature of oun Auditor/County r-corde County \ Date month,day,year)
c -.Smith , c� S�o'n - N-2)020