HomeMy WebLinkAboutAge_Goebeli�„_ �•n 4 AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE,
` REQUESTING DEDUCTION FROM ASSESSED VALUATION
�� ,��� ✓ State Fortn 43708 (R6 / 4-04) �
Prescribed by ihe Depariment of Lowl Gavemment Finance
vFormation contained in this document is CONFIDENTIAL pursuant to IC 6-1.7-72-9 and IC 6-�.135•9.
INSTRUCTIONS:
To be filed in person o� by mail with the CountyAuditor of the county where
the property is located.
See reve�se side
Is tha property in questlon:
property ❑ Mobile home (/.C. 6-f-f-7)
-od
❑ Yes .8'Ro I
I/We certify under penalty of perjury that the above and foregoing informalion is true and correct and that the applicant was a resident
of Indiana and owner of the aforementioned property on March 1, 20 _
execufed Power o/AttomeyJ
of applicant � I '� � �,� (�7'6 �ress of aulhorized represenlalive