HomeMy WebLinkAboutAge_DeckerAPPLICATION FOR SENIOR CITIZEN
. PROPERTY TAX BENEFITS
� ` .. ' Stdb Form 43708 (R9 / 9-08)
PrewibeE by Me Depamnern of Local Go.emmem Fina�e
Ir�forrriatiom m�tained in Nis documenl is CONFIDENTIAL pursuant fq IC 6-1.1-12-9 and IC 6�1.1-35-9.
COUNTY TOWNSHIP � YEAR j
� ��� .
File Mark
�uN 1 0 2oos
INSTRUCTIONS:
7o be filed !n persm or by mail with Ure CounfyAud"Rw o/ the county wheie fhe property is located. ��� ��
Fdirg Dates: 1) Real PiopeRy: Dunrg the 1weAre (12J maMhs 6e/ae Decembar 3f o/ fhe ysar the deUuction is to bGe �eqNCective.f!�1���
2) Mobile Homes assessed under IC 67.7-7 ormanNaIXUred homes rrot assessed as real propeRy: DUmig� tnm�e���2Yrrftiriiii�TOR
before March 31 0l Ne year fhe deduction is to 6e eflecfive.
See reverse side fa add4ionel insVUCtloru e� qualifications.
TYGe W beireffi re0uested W�ease Meck a0lhat aPdY)
Over 65 Deduction from Assessed Valuation Over 65 Cirwit Breaker Credit
Nama of apd�M (owrrer or cakracl buye
/
f b ��E
,
Is iprit the sda lagal or eQUiWWe owneR It N, is hiaAar exed ahara or inie�esl7 tt ovmed with someane othar than soovse,
inditate with whom
❑ Yes ❑ No
H name on racord'n d'iRereM Man thal o( eppliran� indicate balow
Name oi mnlad seller (apWicant musf hare Oean Duyiip on contrad a1 kest ora (7) yea�
Addeass M mntratl m0ar (numbwaM sbeeC rily, sfata, a� ZIP m0o) Is the o�PeM �� aues�ion:
� N I Real property � Mobile home QC 644-7)
J�...
Tazing � �riG Key number / Lepal descnption Record number Page r.umcer
a�G—//�.3G _/OD- D� i�i�.3—
�
U Uie p�opery used an0 ottu ed pnmarily br AssesseC value of Ihe O�DeM as of March 1, currant year (may rrof exceed 5 f 62.4?0
tus/har residenm7 fir O�ei 65 deduction. a Sf60.000 !or Na Ove� 65 Circ�e &oaker GadiQ
Yes ❑ No
Was Ne eppfi�nt 65 yean o( age w mrne on December 31 01 the year
Hava you Ned for arry other deductions7 If 19s, what deducUOns7
� Yes � No
Mava you fiied for Oeduc�ons in any other coumyl If 18s, whaf counry?
� Yes ❑ No
I/VJe certify under penalty of perjury that the above and (oregoing information is Irue and corzect and lhat the applicant was a residenf
of Indiana and owner of the aforementioned property on March 1, 20 _
Sgnature d icam AdE�ass of epplimnt (numba eM aboot, ciry, sfafe, eM ZIP code)
�_ ' o �. vU ; s ODS "
5' ature d authonzeO re0�eritative Addrasa of autlronzed representa�ive (n✓mberanE aboof. ciry, sfale, and LP code)