HomeMy WebLinkAboutAge_Tucker (2)`
i23 R9.�aM 1981
6ea by Ne Sap
iia. Cociei@sioners
.
�
�
AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE
RE�UESTING PROPERTY TAX DEDUCTION
TO BE FILED IN PERSON OR BY MAIL EACH VEAR WITH THE
COUNTY AUDITOR WHERE OWNER'S PROPERTY IS LOCATED:
REAL PROPERTY BETWEEN - BETWEEN MARCH 1 AND MAY 10, INCLUSIVE
MOBILE HOME - BETWEEN JANUARY 1 AND MAHCH 31, INCLUSIVE
(NOT ASSESSED AS REAL PROPERTI�
'� (57.1-12-9 AND &1.1-12-10.1)
STATE OF INDIANA, o��v8a.e,-�- COUNTY, SS:
�
�years of age on the_�
%That I, (We) reside at
, ��%�.�" , _� c�Township,
(City or Town)
��,��_e--,-�- County, Indiana; that I, (We) have owned the following described
L`i' real estate for 1(one) year or more prior to claiming this deduction, and that I, (We) now reside in
❑ mobile home
the premises for which this deduction is claimed:
Surviving Spouse: If application is being made by surviving unremarried spouse:
Spouse's age at the time of death: .
Name of property tax records if different from above: .
Legal Description or Key Number: �s, f L?�v� r�.�X �S� 0�3-ooy18
value of real estate or mobile home as of March 1, current year:
Were either ou or your spouse required to file an income tax return for the preceeding year?
Yes � No . If yes, a copy of such return must be submitted for county auditor's
inspection.
Other than a Mortgage Deduction, do you receive any other deduction from property tax?
r Yes No ��
�ave you filed application for deduction in this county or any other county? Yes , No �—
I swear under the penalty of perjury that the above and foregoing information is true and correct.
'See Fals tatement Pen ty Below. (On Receipt)
( '
Filed B�. � Address Phone No.
I
On Behalf Oi: (Owne�'s Full Name) _ i. (Owner's Complete Address)