Age_Lindauer"' „ APPLICATION FOR SENIOR CITIZEN courm TOWNSHIP v�
__ , PROPERTYTAXBENEFITS
•S Sfate Fortn 43708 (R9 / 9-08)
� Prascribed by Iha DapartmeM of Loral GovemmaM F�nance
� • ile a
Informatiom m�tained in lhis documenl is CONFIDENTIAL pursuant to IC 6-1.1-12-9 and IC 6-1.1-35-9.
C�I
�,
lNSTRUCTIONS:
To 6e filed in person or by mail with Ure CourttyAudHor a7 the county wheia lhe pvoperty is locafed. MAY 1 2� I Z
Filing Dates: 7) Real Property: ��ring the hveNe (72) monfhs 6e/are Decsmber 37 07 the ysar the tleduction� t be eR ".
2J Mobile Hanes ascessed under IC 6-1.1-7 or manu/adured hanes iwt assessed es real prope� unrg (12) months
Aef .e II�.M '1� ni I6a v n� /M1n dulrr�Fnn ie In Aa aflorlva C
See ieverse rnle loraddi6onal insLUCtions and qualificafions. ON COUNTY AUDITOR
Type of benaft reQuasted (plea eNc a0 Nat appiy)
Over 65 Deduction 6om Assessed Valuation Over 65 Circuit Breaker Credit
NameotsOP�rtl(ownermcmGac(WyeQ �
�
Is applrcaM Ne sda legal or aduitable . I( No, what is hisfner exad share w inlarest? If ownad with mmeone other Ihan spouse,
indirate wiUi whom
es ❑ No
If `ama on ramd is diHerent Nan Ihat of app6rant, iMuate 6ab.v
Nama ot m�tract se0er (appficant musf have bean buyirrg on confracf af lea5 oire (i) yea�
AAErass d mntratl wller (nienbol ar�E sbaeL �: sfate, aM LP cade) Is lhe p`ope�ty in ques'
al pmperry � Mobile hwne (IC 574-�
Ta�ci�g district Key number/ Legal Cescripfian Record number Page num6er
- -30 -�oo•oby-b�?h
Is a p�oparty used aM arupeE primarily for Psseaad value of the property as ot Marrh t, curtam year (may imt uraod E782.d30
his/ner �eSiEanre7 forO�er 65 dedurfion, or Sf 60.000 /oi Ne Ovri 65 Circuif &oalmrGedr�
es ❑ No
Was Ure epp6aM 65 years of ege or mwa on Decembar 31 year
Mave you filed tn any othar tleCuctions? tl Yas, what tleductions9
�Yes �No
Mave yau (Jed tor ded Wions in any othar munry? If Yes, what wuMy?
❑ Yes ❑ No
IIVJe certify under penalty of perjury thal lhe above and foregoing infortnation is true and cortect and thal the applicant was a resident
of Indiana and owner of the aforementioned property on March 1, 20 _
Signatura W appficaM Address of aOG�m (number and strve4 dry. state, aM ZIP mde)
� G , �..O.a�...-�
Signature dauthonzed raP�%entative P.ddress af authoraed representative (numDrranJ sheot, dty, slate, and LP code)
sp �. U �....�. S� .
�