HomeMy WebLinkAboutAge_Riedford"' APPLICATION FOR SENIOR CITIZEN TOWNSHIP � YEAR i
. PROPERTY TAX BENEFITS
� `... '' StateFortnd3708(R9/9-08) � .
i Prasai6ad by Ne Depattment of Local Govammertl Finante �
Infortnatbm m�tained in this doament is CONFIDENTIAL pursuanl to IC 6-1.1-12-9 and IC 6-1.1-35-9.
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INSTRUCTIONS:
To be filetl in persm or by mail wrth fhe CounlyAudita o/ fhe county wfiere fhe property is Ixafed. ��� �
Filirg Dafes: 7) Reel PropeAy Dunng Ure tweNe (12) marths before Decem6er 37 olthe ysar the deduction�l �$��pf��(.�TY AUDITO�
2J Mo6de Homes essessed under IC fi7.7-7 ormanufacturetl hwnes rrot assessed as /eal property: Dunrg the twsNe (12) mon s
befae Marci� 37 0l the yeer Ne tleduction is to be elfective.
See reverse sitle lor adrlifional insUVCtions arW Qualificelims.
Typa o( benef.t �eGUasfetl (please Meck e6 Nal e�
�Over 65 Deduction 6om Assessed Valuation �Over 65 Circuit Breaker Credit .
Nameotap0licaM(ovmeforcmt2cf0u�eh ,
Q �
b epPlimrtl Ihe sde lepa eQuitable o.men H No, whai is hisRier exact share or interast? H ownatl vnth wmeone other than spouse.
indinta wit� wtam
❑ Yes ❑ No
M name on record is diflarenl ihan that d eppfimnt ��7icate babw
Name of contrad se0er (applitant mvsf fuve Dean Duyirg on conf2cf at least o�ro (1) yna�
Pddraas d contraU sallar (num6erarM sboal, ciry, stefo, eM Z/Pcode) �s the pmo in ouestion:
Real Oroperty � Mo6ile home (IC 644-�
� Taaing distnd Key numSer I legal descnption I Record num0er I Page number
-l8-3b - yoa - 000. -3ay-oo 9
U Ihe property used aM ottuped prinuNy br Assassed value of the properry as of March 1, wrreM year (may nof exceed Sf 82,a70
his�her reaiden�T /or O�er 65 dM�rlian. a f760,0001or Na Ovor 65 Circuit &eakcr Credr�
❑ Yes ❑ No
Waa lhe eppficaM 65 years of aga w rtrora on Oecember 31 ot ihe year
Hnve you filed for a�ry athar datluctiw+s7 If Yas. wf+at deducoons?
�Yes ❑ No �,s.
Have you filed for deductions in any other cwMy7 If l§s. what coumyl
� Yes ❑ No
IIWe ceNfy under penalty of perjury that the above and foregoing information is We and covect and that the applicant was a 2sidenl
of Indiana and owner of the aforementioned property on March 1, 20 � �
Sipnature of applkafrt Pddrass of e0o��1 (nurn6eraib streel, ciry, stata, antl Z/Pcode) ,
� �� � .
Sipnatura of eulhoriz�tl reo�eserrtaWe Fc'drasa of e�thwized repraseniativa (namCeraM sWet, tiry, state, an LP code)