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.�•°'° AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE,
e =- � County Township Year
_ _:� ,. 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
mustfilebetweenJanuary 15and March 31. See reverseforadditional instructions
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Applica t O er or o tract.buyer) ITOR
Is applicant the le legal or If no, what is his/her exact share or If owned with someone other than
equitable owner? �S�yes O no interest? spouse, indicate with whom.
If name on record is different th�a.n�hat of ap�ant, indicate below: _
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Name of contract seller (Applicant must h e been bu ing on contract at least one (1) year.)
Address of contract seller
g Distri t Ke Number/Le al Des iption �p/ Record No.
� � . I8 �o 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?
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
�nature Authorized Representative (by executed Power of Attorney)
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Address of A licant Address of Representative .
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