HomeMy WebLinkAboutAge_Graper.�•°'TMO'� AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE,
-°� � 4 REQUESTING DEDUCTION FROM ASSESSED
VALUATION State Form 43708 (1-90) Prescribed by the
�°� State Board of Tax Commissioners
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Instructions for filing:
To be filed in person or by mail with the County Auditor of the County where the
property is located during the 12 months before May 11 of the year the deduction
is to be effective. Deductions for mobile homes not assessed as real property
must file between January 15 and March 31. See reverse for additional instructions
and
interest? spouse, indicate with whom.
If name on record is different than that of applicant, indicate below:
Name of contract seller (Applicant must have been buying on contract at least one (1) year.)
Address of contract seller
�in District Key Number/Legal Descri tion Record No.
�(��i —�_ __-_ r (� Page No.
I the real propert used and occupied primarily Assessed value of the property as of March 1, current
for his/her residence? O yes O no year (may not exceed $19,000).
Was the applicant 65 years of age or more on
Have you filed for any other deductions? If yes, what deductions? . ,
Have you filed for any deductions in any other county? If yes, what county?
IlWe certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
cant was a resident of Indiana and owner of the aforementioned property on March 1, 19
Signature Authorized Representative (by executed Power of Attorney)
Addr s of Applicant Address of Representative
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