HomeMy WebLinkAboutMortgage_Allen (15) 4`6' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R13/10-15) A r- Gibson Owensville 2020
a Prescribed by Department of Local Government Finance RE�°6�I� I
AUG 1 b 1019 File Mark
INSTRUCTIONS: 014
Form filed with:
7e bet filed In papaw or by mDll,
Filing Dates: 1)Real Property:Must be comple and dated in the calendar year for which the deduction is sought. County Auditor
Must be filed or postmarked with the County Auditor or County Recorder of the county where the '❑ ` County Recorder
property is located on or before January 5 of the immediately succeeding calendar year.
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)
Jeffrey K.Allen ,
Taxing District Key number/legal description Record number plkriuLrtz.
Owensville 26-17-12-204-000.008-022 eb010
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 al or equitable owner?
$106,000.00 209,000.00 Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with who
If name on record is different than that of applicant,indicate below: Is a property in question:Annually Assessed
Real Property 0 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, Suite 220, Fort Wayne, IN 46804
Name of assignee or other owner or holder of mortgage
I
Address of assignee(number and street,city,state,and ZIP code) .- - - . -
AG 4200 -
Does applicant own property in a 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 .rar? ElNo
A person is not entitled to this deduction unless the person has a balance on tiquerso 11!( ` ontract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in t0r?R a eNsT cklj> rioNe basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County ts� � County Jcv Date(mDlth.,d2 y,_year)
I/We certify under the penalty of perjury that the above and foregoing information i and correct and that the applicant ra a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
ignature own e mr' Date(month,day,year)
08/07/20
r ent address of applicant(number and street,city,state,and ZIP code)
4 4 S Third St, 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. 45772