HomeMy WebLinkAboutMortgage_Johnson (4) +?,, County STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Township Year
" FOR DEDUCTION FROM ASSESSED VALUATION
5i `" t'/� State Form 43709(R13/10-15) REg�EI®/ ® G 1
. (so f\ Y l' e • aop�O
y 1e% Prescribed by Department of Local Governme t Finance
INSTRUCTIONS: ( p��%O APR 212020 File Mark
To be filed in person or by mail. OCA J "U ��i Form filed with:
Filing Dates: 1) Real Property: ust be comp) t d and dated in the ca endar year for which the deduction is sought.
Must be filed or postmarked wit the County Auditor or County Recorder of the county where the property is X 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)
Kevin P. Johnson
Taxing District Key number/legal description Record number P e u ber
Owensville 26-18-06-303-000.728-022 2024 ,
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
assessment date,current year assessment date,current year date of application legal or equitable owner?
$125,000.00 El Yes LI No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the property in question:Annually Assessed
❑✓ Real Property ❑ Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Ruoff Mortgage Company, Inc. FT IL Al Fes`=3
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) I � n i
1700 Magnavox Way, Ste 220, Fort Wayne, IN 46804
Name of assignee or other owner or holder of mortgage APR 2 2.2020
Address of assignee(number and street,city,state,and ZIP code) .
Does applicant own property in any If yes,what county? What Taxing District? Has this efin yr ( e@¢$tatesTdd P itf.WsT amount of deduction
other county on-property for
in Indiana? ❑Yes 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 20 20 20 20 20 20
IS
Signature of County Au County \ Date(month,day,year)
tr11 1 30\n 1-1-2:2-?fp20
1/We certify under the penalty of perjury that the above and foregoing information is tru nd correct and that the applicant is a resident of Indiana and.
owner/contract buyer of the aforementioned prop rty on date application is filed.
•
Signature(owner's full name) Date(month,day,year)
lm--- ).
Wti-- 04/01/2020
Full resident address of applicant( mber and street, ty state,and ZIP code)
204 E Rock Rd, Owensville, IN 47665
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.