HomeMy WebLinkAboutAge_Whited�� rt•�4t AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE,
� RE�UESTING DEDUCTION FROM ASSESSED VALUATION
.a ,
Stare Porm a3708 (R / 9-96)
�"' Prescnbed bY the State Boartl of T� Commissioners
In:ormation contained in this documem is CONFIDENTIAL pursuam to IC 6-7.1-72-9.
INSTRUCTIONS FOR FILING:
To be liled in pe�son or by mail with the Covnty Auditor ol the county where the property is loca-
ted during the 12 months before May 7 7 0/ the year the deduction is to be eflective.
Deductions lor mobile homes not assessed as ieal property must lile beRveen January 75 and
March 31.
See reverse side Ior additional instruction and quali(ications.
�oya�plicani (owner or
� �,�
a
name on record is ditterent
ame of contraci seller (app,
ddress of contract seller
Is the property use
hismer residence?
owner? I I( No, what is
�Yes ❑No I
than that of applicant, indicate below
must have been buying on crontract at /easr one (7) year)
the applicani 65 years oi age or more on
to the current yeaR
Applicanfs tlate oi bii
�-
the time of death?
Have you filed for any
Have you filed
spouse.
any
Key number / Legal description
�� � � �
Assi
exce
❑ Yes ❑ No
December 37 of the year
❑ Yes ;� �
IIVJe certify under penalty of perjury that the above and foregoing information is true and correct and that ihe applicant was a resi-
dent of Indiana and owner of the aforementioned property on March 1, 19
G/ �
�ess ot appliwni �. �. �L � �J! �� �
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