HomeMy WebLinkAboutAge_Wheaton.Faem 7I3-xevisee t580
RescriMV ty �Ae.S�ale
BmrE o� Tav Commissiwers
�•
STATE OF INDIANA,
I, (We)
AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE
REDUESTING PROPERTY TAX DEDUCTION
TO BE FILED IN PEPSON OR BY M/IL EACH YE/N WITH THE
COUNTY AUDITOR WHERE OWNER'S PNOPEFTY IS LOCATED:
HE/.L PHOPEPTY � BETWEEN MARCM 1 AND MAY 10. INCLUSIVE
MOBILE HOME � BETIVEEN JANUARY 1 AND MANCH 31. INCLUSIVE D O I � O II �.JJ
� (NO1 ASSESSED AS HEAL PROPENTY)
(F1.143.9 AND 61.142-10.1)
COUNTY. SS:
certify that I, (We) was/were
I� years of age on the — Thaf I, (We) reside at
Q.{�. a�'" �a 3$ , Y_X�s2.�v-".oc , UM+'� Township,
(STflEET Ofl fiURAL RO�TE) ICITV OR TOWN)
"� �� �� County, Indiana; that I, (We) have owned the following described
�./V.�+vv
�al estate
for 1(one) year or more prior to claiming this deduction, and That I, (We)
❑ mobile home '
now reside in the premises for which this deduction is claimed:
Surviving Spouse: If application is being made by a surviving unremarried spouse:
Spouse's age at time of death:
Name on property tax records if different from above:
Legal Description or Key Number: v�• Nw /y `S��`� aa -3- 9
n .NWy� a3-3-9 4.°�
�sessed value of real estate or mobile ho,m�e as of March 1, current year: —
S � �4-
�• �
Were either you or your spouse required to file an income tax return for the preceedi��r�e
No If yes, a copy of such return must be submitted for county auditor's i ti n
Other than a Mortgage or Contract Deduction, do you receive any other deduction ,,f�A rRq tax?
s NO _�� ave you filed application for deduction in this County o���Sii� �t�fet���unty?
,�s NO ��
�j�/�,� �y���^'�,,-�•S
I swear under penalty of perjury that the above and foregoing information is true a"nd corp�jj�R "
'See F�Is� Statement Penalty Below. (On Receipt) m n' n n.,
� _ / ��1 ,?__-. fi �