HomeMy WebLinkAboutMortgage_Ruff esaxm�*•. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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j' � FOR DEDUCTION FROM ASSESSED VALUATION CD State Form 43709(R13/10-15) (&5Q� O 1
°+ , ,,. ✓' Prescribed by Department of Local Government Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail. F rm ilea with:
Filing Dates: 1) Real Property: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 is 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)
Ruff, Cavin & Hoover, Riley
Taxing District Key number/legal description Record number Page number
Columbia 26-14-07-300-000.308-006 02oa0 5 y'
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?
$322,059.00 0 Yes ❑ 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
0 Real Property 0 Annually Assessed
. Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller T T �j
Address
Bran of oEngland,
mortgagee or o tact SIAOA/ATIMret.city,state,and ZIP code) FILED
PO Box 3490, Little Rock, AR 72203 �J
Name of assignee or other owner or holder of mortgage
MAY 2 21122
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in y If yes,what county? What Taxing District? Ha. tt5' 4164„;n49yes,state amount of deduction
other county or fypq�rf vc �Y I�t J OR
in Indiana? El Yes No curren�E_year?
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or on ct 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 offs )tha ' the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Audit County
County V� Datesc nt_h, y °'
f\rW
I/We certifyunder the penaltyof perjuryuabove and foregoing information is truuOnd correct and that the applican i a r sident Indiana and
owner/contr ct buyer of the orementioned property on date plication is filed. / (�� �/
Sig ature(o s full name) Date(month,day,year)
• 04/29/2022
Ful re dent address of applicant(number and street,city,state,and ZIP cog_j---
455 South State Road 57, 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)