HomeMy WebLinkAboutAge_Arnold,1 fmn 323 RenSetl 198 i
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STATE OF INDIANA,
AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE
RE�UESTING PROPERTY TAX DEDUCTION O/1M��7�
TO BE FILED IN PERSON OR BY MAIL EACH YEAR WITH THE 6J��
�COUNTY AUDITOR WHERE OWNER'S PROPERTV IS LOCATED:
REAL PROPERTV BETWEEN • BETWEEN MARCH 1 AND MAY 10, INCLUSIVE
MOBILE HOME • BETWEEN JANUARY 1 AND MARCH 31, INCLUSIVE
(NOT ASSESSED AS REAL PROPERT`�
(61.1-12-9 AND 61.1-12-70.1)
, .�.5:
I, (We)�� ��' ��� �k � , certify that I, (We) was/were
�years of age on the , . That I, (We) reside at
R r`� i�'f 7`/V1 , Township,
(SVeet or Rural Route) (City o �
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County, Indiana; that I, (We) have owned the following described
❑ real estate for 1(one ear or more prior to claiming this deduction, and that I, (We) now reside in
❑ mobile home�
the premises for �'Fiicli,tliis7deduetion is claimed:
Surviving Spouse: Iftia�plicafi0r�?±s being made by surviving unremarried spouse:
, Sp'ouse's age at the time of death: �
Name of property�axicECOr�ds�d�erent from above:
AU01 i V+� � q �1
Legal Description or Key Number: �� � a �V �� 14 3- o�—�� 3�: � oC f� �-
value of real estate or mobile home as of March 1, current year: lDo2O,-/S
...$
Were eit r you or your spouse required to file an income tax return for the preceeding year?
Yes , No If yes, a copy of such return must be submitted for county auditor's
insNecuui i.
Other than a Mortgage eduction, do you receive any other deduction from property tax?
Yes No .
3ve yoU filed application for deduction in this county or any other county? Yes , No
� I swear under the penalty of perjury that the above and foregoing information is true and correct.
`See False tement Penalty Below. (On Receipt)
I �_
File 8y: Address Phone No.
Fu0 Name)
(vwners comprere Aaaress
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