HomeMy WebLinkAboutAge_Smith (6)d.+`R�'�v� AFFIDAVIT OF PERSON, 65 YEARS OF�AGE OR MORE,
� REQUESTING DEDUCTION FROM ASSESSED
� VALUATION State Form 43708 (1-90) Prescribed by the
�° State Board of Tax Commissioners
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
mustfile betweenJanuary 15 and March 31. See reverse foradditional instructions
anri niialificatinnc
County Township Year
File Mark
I�'�'ll�
' �
�'�� 2 2 1995
'.._ _�__. __.__ _ � w a/ . � C
Applicant (Owner " r contract buyer) . AUDITOR
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Is appli ant the o legal or If no, what is his/her exact share or If owned with someone other than
equitable owner? �es O no 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
ing istnct f� Key Number/Legal Description Record No.
� �cS�J (Q" _� _��'-�`—� Page No.
Is the real property used and occupied primarily
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
ature `Authorized Representative (by executed Power of Attorney)
� ��� R�����'
Address of Applicant i(y`-"'-�`J Address of Representative
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, �76 g.