HomeMy WebLinkAboutAge_Redfairn" APPLICATION FOR SENIOR CITIZEN
= PROPERTY TAX BENEFITS
State Form 43708 (R9 / 9-08)
� S�u � Pisscnbed Gy Me Depaitrnenf of Local Govemmenf Finante
Infwmatiam m�tained in this dowmenl is CONFIDENTIAL pursuant to IC 6-1.1-12-9 and IC 6-1.735-9.
COUNN � TOWNSHIP � YEAR j
Fi M rk
INSTRUCTIONS: no 4 tQj(J
To be fileC in person or 6y mail with the CountyAudifw o/ the munty where the property is locafed. M F'`n O J
Filiry Dates: 1) Real Pioperty: Ounng the MreNe (72) months be/ae December 37 o7f6e year the tleduction is to be e8ective.
2) Mobile Homes assessed urMer IC 67.1-7 or manulacluretl homes rrot assessed as real property: During the t�9�b�1�1 m�
be/ore Maich 37 0l the year fhe tletluction is to 6e eHecWe. ��
See reverse siUe /a aedaiona� insfiutions and Qualifica6ons. pIBSON CQUN� Y AI�Qlfi@�
Type ot baneH repueat (pleato dixk a0 Nat apply)
Over 65 Deduction from Assessed Valua6on Over 65 Circuit Breaker Credil
Name of aoo�M ( a taH2U DvyeQ //�� ,
ci/ / �' �
Is a iant Me sde lepal or eQUitaWa owneR It No, what is �islnar exad s�are or intere517 If ownad wii� saneone mher ihan spouse.
inditate with whom
� Yes ❑ No
tl nama on racord is diRerarit than iha� o( aDDrx'anl, indicate 6elaw
Name d cont2p sellar (appGcant must Aava been bynig on conLad af least one (1) yearJ
Address of mntratl seAer (numba aM streef, cdy, state, aM ZIP m0e) �5 tne D�Oerry in Quasl'qn:
IRI Real property ❑ Mobile home QC 644-�
r--��
� Tazingdislrid Keynumber/Legaldeacnplian Recordnum6er PaganumDer
�-iA���F�- c��-o�-�9-/o%aoo.a�a_
Is ihe O�PeM used aM ocwqed pnmaiy br Assessed value of the o�PeM as of March 1, wrtem year (may mf erceatl f iB2,<30
hiaTher �esidenw7 (o� O�er 65 tletlueian, or Sf60,000/a Ne Owr 65 Cimcl &eaker Gadi�
�Yes ❑ No
Waz Me appliraM 65 yeers ot ape w more on December 31 of Ihe year
Mava you filed for airy dher Eatluctions7 If Yes, what deductions?
� Yes � Mo
Mave you fiied for Eeduttions in any other tourrtyl If T§s, whaf county?
❑ Yes ❑ No
IIWe certify under penalty of perjury that the above and foregoing information is Irue and wrrecl and that the applicant was a residenl
of Indiana and ownei of the aforementioned proparty on March 1, 20 _
sg�at�reoraoWwrrt - n.dd�sso�aooi�m��l��berantlstroetcily,stale.aMZ/Pmde)
�L. �,�,� d.v-i.� , S 1 3�,a.,�' Ce„�'� $�' l �^-� `i 7�� D
Sipnalure of aNhonzed rep�eaeMawe Address ot authorized reoresenta�ive (numberantl swof, ciry, stafo, antl LP code)