HomeMy WebLinkAboutAge_Schmitt• o AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE,
d t REQUESTING DEDUCTION FROM ASSESSED
'��� VALUATION State Form 43708 (1-90) Prescribed by the
•• State Board of Tax Commissioners
�
Instructions for filing:
To be filed in person or by mail with the County Auditor of the County where the
property is located during the 12 months before May 11 of the year the deduction
is to be effective. Deductions for mobile homes not assessed as real propert
mustfile betweenJanuary 15 and March 31. See reverseforadditional instruction
and qualifications.
County � Township� Year
MAY 0 8 iyy�
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Applicant (Owner or ntract buyer) I . •
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Is applicant the sole e� f o, what is his/her exact share or If owned with someone other than
equitable owner? yes interest? spouse, indicate with whom.
If name on record is different than that of applicant, indicate below:
Name of contract seller (Applicant must have been buying on contract at least one (1) year.)
Address of contract seller
T•�ng Di rict Key Number/Legal De cri ti n Record No.
` �- -'��� Page No.
Is e real property used and cupied primarily Assessed value of the property as of March 1, current
for his/her residence? � s O no year (may not exceed $19,000).
Was the a licant 65 years of age or more on ApplicanYs date of birth _`
Does the combin d annual adjusted gross
Have you filed for any other deductions? If yes, what deductions?
Have you filed for any deductions in any other county? If yes, what county?
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
cant was a resident of Indiana and owner of the aforementioned property on March 1, 19
�tu Authorized Representative (by executed Power of Attorney)
. � '?1
Address of Ap i ant Address of Representative ,
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