HomeMy WebLinkAboutAge_Stewart°'no AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE,
a � County Township Year
REQUESTING DEDUCTION FROM ASSESSED
� VALUATION State Form 43708 (1-90) Prescribed by the
S •• �1. State Board of Tax Commissioners -
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Instructions for fiiing: File Mark
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
mustfilebetweenJanuaryl5andMarch3l.Seereverseforadditionalinstructions �����
and qualifications.
Applicant (Owner or contract bu er
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Is applicant the sole le or If no, wha his/her exact share or f wn er than
equitable owner? es ❑ no interest? sQI886E�, gteaieritT'ofoh m.
If name on record is different than that of applicant, indicate below:
Name of contract seller (Appiicant must have been buying on contract at least one (1) year.)
Address of contract seller
` ing istrict Key Number/Legal Description Record No.
� � b — ��5��—�� Page No.
Is the real property sed and ccupied primarily Assessed value of the property as of March 1, current
for his/her residence? r s❑ no year (may not exceed $19,000).
a
Was the pplicant 65 years of age or more on
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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?
I/We 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 �
Si nature Authorized Representative (by executed Power of Attorney)
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Address of Applicant �� �✓��'(/� I Address of Representative �a
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