HomeMy WebLinkAboutMortgage_Brittingham E1. , STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
i ii it FOR DEDUCTION FROM ASSESSED VALUATION COlw iFjq
r r i 011 State Form 43709(R11 6-09) Gibson Oakasfld City 2020
���. Prescribed by Department of Local Government Finance RECEIVED
INSTRUCTIONS: R 1 — OCT 2 1 2U20 File Mark
To be filed in person or by mail.
Filing Dates: 1.) Real Property: Must be completed and dated in the calendar year for which the deduction is sought. Form filed with:
Must be filed with the County Auditor or County Recorder of the county where the property is located
on or before January 5 of the immediately succeeding calendar year. County Auditor
2.) Mobile/Manufactured Home not assessed as real Property: Must file with the County Auditor of the ❑ County Recorder
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. 26^lS ^'S—1)0 1 - 00l 0il"006
Applicant(owner or contract buyer—see restrictions on reverse side)
* Jacob A.Brittingham
Taxi Dis ct Key number/legal description Record number Page Dumber
* O( * Section 13,Township 2, Range 9 * low 56
Assessed value of real property as of Mortgage/Contract indebtedness unpaid Mortgage/Contract indebtedness Is the applicant the sole
March 1,current year as of March 1,current year. unpaid as of date of application legal or equitable owner?
* $0.00 * $0.00 * $0.00 ❑x Yes ❑ No
If no,what is his I 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
❑X Real Property ❑ Annually Assessed
f , i Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller ' A.
* 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 OCT 22 2020
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street, city, state, and ZIP code) )0614
",, ,,
GIBSON COUNTY AUDITOR
Does applicant own property in any other In yes,what county? What Taxing District? Has this deduction been requested on property
county in Indiana? for current year?
❑ Yes ❑ No ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20 __
Signature of County Auditor '♦ County Date(month day.year)
I/We certify under the penalty of perjury that the above and foregoing information is��e and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
St a. (o ner' full na � Date m ear)
"Full resident address of applicant(number and street, city, state,and ZIP code)
* 11015 E 100 S, Oakland City, IN 47660
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)
RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
Name of applicant a of m gagee or contract seller
Jc h .�'i ;� MCAT atie of t Ire. 73
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Date fil m t , da year mount of indebtedness axing District n fj sl
Key number/legal description FI-F---:,-
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Signature p�Cqunty j itor/ order 0(^T County S'O� Date(month, day,year) r,
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GIBSON COUNTY AUDITOR
Statement of Mortgage or Contract Indebtedness IN2012293