HomeMy WebLinkAboutAge_Weedmanej ��°o AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE,
-`� REDUESTING DEDUCTION FROM ASSESSED VALUATION
State Form 43708 (R / 9-96)
�'�, Prescribed by Ihe State Board of Tar Commissionere
Intormation contained in this document is CONFIDENTIAL pursuant to IC 6-7.7-72-9.
INSTRUCTIONS FOR FILING:
To be liled in person or by mail with the County Auditor o/ the county where the property is loca
ted durinq the 72 months before May 77 0l the year the deduction is to be el(ective.
Deductions lor mobile homes not assessed as real propeny must lile benveen January 75 and
March 31.
See reverse side lor additional instruciion and qualilications.
ame of ap ican
,�
applicant the si
name on recorc
ame of contraci
(owner or contract buyer
� � ������
= le. al or equitable owner? If No, what is hi�/h
contraci
must
�fJ-�✓C �
Is ihe property usE
his/her residence?
❑ No
on contract
�-,
one
0 //— Dv��7—o u
�"Yes ❑ No
Was the applicani 65 years of age or more on December 31 of the year
prior to the current yeaR
� S �
Applicanfs date of binh (month, day, yeai)
/
If filed by a surviving, unmarried spouse. what was the spouse's age at
the time of death?
Have you filed for any oiher deductions?
Have you filed for deductions in any other
❑ Yes
❑ No
COUNTV TOWNSHIP YEAR
File Mark
���� �
' �'..
� �...i � _.Y ._ .
APR 0 j 2000
tl ownetl wrth Someone other than spouse,
indicate with whom
number
A55essetl value of lhe property a5 of March 1, current year (may nof
� $
e S 7`e�.�
IlWe certify under penalty of perjury that the above and foregoing information is true and correct and thai the applicant was a resi-
dent of Indiana and owner of the aforementioned property on March 1, 19
1
of ap�fJlcant �Address of authorized representative