HomeMy WebLinkAboutMortgage_Mann (2) ,� T��q. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ounty Township Year I
y �' �— 2022
h FOR DEDUCTION FROM ASSESSED VALUATION
Cs _r •,i State Form 43709(R14/1-20) Js C�2
%, --- Prescribed by Department of Local Government Finance File Mark
sole
INSTRUCTIONS:
To be filled in person or by mail. Fo m d with:
Filing Dates: 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 is located on or before January 5 of the calendar year in which the property taxes ae first due County Auditor
and payable. 0 County Recorder
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Nathan R. Mann and Amanda E. Mathis
Taxing District Key number/legal description 26-17-01-404-000.111-022/308 N Main St. Record number Page number
22- Owensville, Indiana 47665
26-17-01-404-000.111-022 , .7Q
Assessed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the ap nt the sole
assessment date,current year assessment date,current year date of application legal o quitable owner?
$123,300.00 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 belTo�r.1ILED Isthe perty in question: Annually Assessed
1 eal Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller MAY
5 ZO22
Ruoff Mortgage Company Inc.
Address of mortgagee or contract seller(number and street,city state,and Zlodel`.
1700 Magnavox Way, Fort Wayne, IN 46804 4/� �G vjj//�la//UDITOR
Name of assignee or other owner or holder of mortgage GltsbON COUNT /!^
Address of assignee(number and street,city,state,and ZIP code) W l /�
Does applicant own property in any If yes,what county? hat Taxing District? Has this de ��'uctio been requested If yes,state amount of
other county on property for deduction
in Indiana? ❑ Yes ❑ N current year? Yes No
A person is not entitled to this deduction unless the person has a balance on the person's mortgage or co r 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 office)that the basis for the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,year)
\'rc �-k P .n� Ce� ti CL, % s e-,r � p z z,
.
I/We certify under the penalty of perjury that t b.above and foregoing information is true and correct and that the applicant is a resident of Indiana
and owner/contract buyer of the aforementioned property on date application is filed.
Signature(owner's full name) Date(month,day,y
Full resident address of applicant(number and street,city, state,and ZIP code)
308 N Main 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)