HomeMy WebLinkAboutAge_Green (3)DULY ENTERED fOR TAXATION
� Subject to iinal ac *-nce (or transfer
"' APPLICATION FO�Nfp CITI� � day of courtnr TOWNSHIP � YEAR
. PROPERTY TAX B��IEF�$ --
Stafe Fortn 43708 (R9/ 9-08) ��pn ,q � �
� S �r � Prasai6ed6ytheDeparLmeMOfLoralci9yir�fi�e�Fi7an�010 AU il0f
(f File Mark
I�wmation oontained in Ihis tlocvment is CONFIDEN71_AL purs t IC 61.1-12-9 and IC 67.1- 9.
��(a�« �� Parcel a
wsrnucnoNS: ����N P��UNT � I�DITOR
To be fileC in person or by maA with Ure Cou a o e coun era fhe property is locatetl.
Filiig Da�s: 1J Reel Propeity: Durirg the hveNe (72) marths before Decem6er 37 0! the year fhe deduttion is to be eflecfnre.
2) MobNe Homes essessed urMer IC 61. 7-7 or manufactured hwnes rrof essessed as real property: Dunrn� the fwslve (72) mmths
6e/ae Mart� 37 07 fhe year the tleduction is to be ei/ective.
See reverse side lor edddional insWdions aM quslifications.
TYOa o( be�ref.t �e0uested (Nease cneck a0 Naf ePdY)
er 65 Deduction hom Assessed Valuation �Over 65 Circuit Breaker Credit
Name of xGd�rit (ownei ar cmhect DuyeQ �
. �
Is apo���i Ne sde I al or eQUitaWe ameR If Na, what ia hisrtier en are w interast7 H owned with saneone other Ihan apouse,
intliwta with whom
❑ Yes ❑ No
I( nama on remrtl is diflarartl Man that W apofrant i'Wicata bebw �
Name of co'rtad selier (appGCanf musl haue Oeon buyirp on cmbacf af leasl orre (1) yea�
AOdress of mntratl seller (numEm aM abeef, city, stale. anL 2/P mtle) Is the prooerty in auestion:
eal property � Mobile home (IC 6-74-n
� Tyrin i ncl Key number I Lepal descnWlon Record number Paga number
-� 6 - ZU I
Is the pmpeM � and occupied pnma' br Assessed valua ol iha prooerty as of March 1, wrent year (may not oxcaod 5182.d30
hi4her �es'Nence7 �or Owr 65 tlodudian, a- Sf 60.000 /or tho P+or 65 Ciic�if &oakor CrodiQ
Yes ❑ No
Was ihe aOW��^� fi5 years of aga or rtrore on Dacember 31 ot ihe year
Nava you fited Iw any olhar daductions? II Yea. what deductions7
� Yes � No
Have you Ned for EeOucGOns in eny othar cwnty9 It Ma, what couMy?
❑ Yes ❑ No
IIWe cerlify under penalty of perjury that the above and foregoing information is true and correct and that the applicant was a resident
of Indiana and owner of the aforemenlioned property on March t, 20 �
Sipnaturedapplirartl AddrasaoteD7liqnt (nwnbaendsWOt.ciry.stafe,arHZ/PCOde) /�,G/n
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/� � .�iy,� �5-"i5" ��.� � � � ��-D.
� Signatura d auMO ed �epresantative Mdrasa of euthwixad reo�ese�tative (number arM shooq <ity, stafo, end ZlPCOdo)