HomeMy WebLinkAboutMortgage_Erusa . ,, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County
01 Township Year
dY' ---' . FOR DEDUCTION FROM ASSESSED VALUATION
0 . - it
, State Form 43709(R14/1-20) RECEIVED Gibson 0 2022
..
. ,.,. ." Prescribed by Department of Local Government Finance
INSTRUCTIONS:To be filed in person or by mail -1----- MAR 0 8 2022 File Mark631tjuryl Form filed 'h:
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 County Auditor
is located on or before January 5 of the calendar year in which the property taxes are first due and payable. E.1 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Ranjith Erusa and Jyothi Erusa
Taxing District Key number/legal description Record number Page number
028 26-12-07-201-000.641-028 2022C606 1652,,
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?
52,500.00 X1Yes El 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
Name of mortgagee or contract seller FILED 00.Real Property 0 ‘kAnril,ylalliy Assessed i
(IC 6-1.1-7)
Ruoff Mortgage Company Inc.
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) MAR 0 8 2022
1700 Magnavox Way,Ste.#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 COUNTY AurtrrOft
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 K on property for
in Indiana? Yes El No A-AMA( Y. ,. current year? IgNes El No 5 ,j'S.‘,0 )
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
J 20 20 20
Signature of County Auditorcylworw (.. ,,) County \
(540A DatIlkdit,year)
I/We certify under the penalty of perjury that the above and foregoing information is t e and correct and that the applicant a re dent of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
-Aignature(owner's full name(
.....4., Date(month,day,year
March MS,2022
Full resident address of applicant(number and street,city,state,and ZIP code)
803 North Race Street Princeton, IN 47670
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,yeat;
March 1.6,2022
Address of authorized person (number and street,city,state,and ZIP code)