HomeMy WebLinkAboutMortgage_Martin (32) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
**kV FOR DEDUCTION FROM ASSESSED VALUATION
Mtitimo. j.4.` State Form 43709 R14/1 20 Gibson 0 2) 2021
Prescribed by Department of Local Government Finance
INSTRUCTIONS: To be filed in person or by mail. lvvve, i „ "L. 1 5 2021 File Mark
Form filed with:
Filing Date: Form 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 ILI County Auditor
is located on or before January 5 of the calendar year in which the property taxes are first due and payable. • County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
ASHLEY T.MARTIN
Taxing District Key number/legal description RT. rce)Zimbfler Pat rah
MOM' 26-11-19-400-000.235-021 1.-\
Assessed v of reMrty as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the app icant the sole
assessment ate,current year assessment date,current year date of application legal or equitable owner?
120,202.00 Es CD 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 th roperty in question:Annually Assessed
Name of mortgagee or contract seller 'J '1. I. i: 4eaI Property Ej Annually Assessed
Mobile Home(IC 6-1.1-7)
RUOFF MORTGAGE COMPANY, INC.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code)JAN 0-5 2022
1700 Magnavox Way,Suite 220,Fort Wayne,IN 46804
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street.city,state,and ZIP code) GIBSON COU 'T
Does applicant own property in y If yes,what county? What Taxing &N District? yji144.tuor. 111"4.2,rarc.
Has this deducti een requested If yes,state amount of deduction
other county on property for
in Indiana? [1]Yes No current year? Yes Cr]No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or o ract 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
Aitc0 County ( Date(mo y, ear)
--.
2,- 2
Signature of County
I/We certify under the penalty of perjury that the e and foregoing information is u and correct and that the applicant i a res ent of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
Sig re(o ner's full name)ss,i(s
WA CVA}Ltt
F Date(month.day,year)
October 15,2021
II res ent address of apli ant(number and street,city.state.and ZIP code)
2342 S Old State Road 65,Owensville,IN 47665-9147
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
October 15,2021
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.
RECEIPT FOR FILING STATEMENT OF MORT 'GE OR • • TRACT INDEBTEDNESS
Name of applicant I Na:50.1 mortga p.-: or contract seller
ASHLEY T.MARTIN 4 ill* 60 •
i.
Date filed(month,day,year) Amount Q1E:bli nis-s 4 Taxing Di
' t c—,
1- 5- - 2,0 '2,1_ 120,202.00 n 2--\ -
Key number/legal description JAN 0 5 2022 `20 2.„‘ - S
1---,,
O
26-11-19-400-000.235-021
1---.)
Signature of County Auditoc.L Couçty Recorder County Date(month,day,net") ..—.
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GIBSON COUNTY AUDITOR