HomeMy WebLinkAboutAge_Frederick•°'° AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE,
��,_ �� REQUESTING DEDUCTION ,FROM ASSESSED County Township Year .
'���� VALUATION State Form 43708 (1-90) Prescribed by the
�•�• State Board of Tax Commissioners
In37ructions for filing: le ark
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 (%�L A-� --1
is to be effective. Deductions for mobile homes not assessed as real property� ,� �o�. � 1�
mustfile betweenJanuary 15 and March 31. See reverseforadditional instructions��
anrl niialificatinns ., i� %i
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Applicant (O ner or tract buyer) • �
Is applicant the sole I I or If no, what is his/her exact share or If owned with someone other than
equitable owner? � y�s O no interest? spouse, indicate with whom.
If name on record is different than that of applicant, indicate below:
Name of contract seller (Applicant must have been buying on contract at least one (1) year.)
Address of contract seller
� ng D strict Key Number/Lega escrip ion 1,`f (�b � Record No.
� _�-3_ —_ _ J'{1� � Page No.
Is the real property d and occupied primarily Assessed value of the property as of March 1, current
for his/her residence? �yes O no year (may not Oceeyl $19�,0,00).
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Was the applicant 65 years of age or more on
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
Signature Authorized Representative (by executed Power of Attorney)
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Address o plicant Address of Representative
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