HomeMy WebLinkAboutAge_WolfeF���'�flev���� AfFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE
PresuiceE ry me 9aie
BoarC oi ia� cor..��ss�a�ers REQUESTING PROPERTY TAX DEDUCTION
TO BE FILED IN GENSON ON BY MAIL EACH YEAfl WITH THE
. COUNTY AUDITON WHERE OWNER'S PROPEPTY IS LOCATED:
PEAL PNOPEPTY - BETWEEN MARCH t ANO MAY 10, INCLUSIVE
� MOBILE MOME - BETWEEN JANUARY 1 AND M4RCM Jt, INCLUSIVE
� (NOT ASSESSED AS NERL PROPEFTY)
(41.1.1]-9 ANO S1.142-00.1)
STATE OF INDIANA, o�h.�JLD1�1 COUNTY, SS:
IY�Ya1
�
certify that I, (We) was/were
—��j
. That I, (We) reside at
(STqEET OR RUFAL ROUTE� �dTV OF TOWN) � D Township,
County, Indiana; that I, (We) have owned the following described
eal estate '
for 1(one) year or more prior to claiming this deduction, and That I, (We)
❑ mobile home • � '
now reside in the premises for which this deduction is claimed:
Surviving Spouse: If application is being made by a surviving unremarried spouse:
Spouse's age at time of death:
Name on property tax records if different from. above:
i.egal Description or Key Number: �! S�L.I��j�-- `
�sassed value of real estate or mobile home as of March 1,
- y�a-
current year:
►��
Were either you or your spouse required to fil�,,� i o �j�{ x return for the preceeding year? V
No If yes, a copy of such return m��b�s��rM�ed for county auditor's inspection.
Other than a Mortgage�r ntract Dedy¢JjD,Q���yo� any other deduction from property tax?
�.. . �.—
�` NO Have you fiSeci ap�(��o deduction in this County or any other county?
,, N O
I swear under penelty of perjury that the above and foregoing information is true and correct.
'See False�Statement Penaliy Below. (On Receipt)
IOwner's Compiete Aaaressl