HomeMy WebLinkAboutAge_Richardson (3)Fwo 43 ReviseU I�0
PresuiOM Ey ��e S�ate
BoarE al ia. Cammissioners
�
STATE OF INDIANA,
�, (�`/e)�
estate
❑ mobile home
AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE
REQUESTING PROPERTY TAX DEDUCTION
TO BE FILED IN FERSON ON BY MAIL EACH YEAR WIiH TME �
COUNTY GUDIiON WHERE OWNER'S VNOPERTY IS LOCATED:
flEAL VqOVERTY - BETWEEN MAPCH 1 ANO MAY 10. INCWSIVE 1 /
I 1
MOBILE HOME - BEiWEEN JANUARY 1 AND MAFCH 31, INCLOSIVE L J
(NOT RSSESSEO A$ NE/L PHOPENTY) � �/
� (61.14P-9 ANp 61.1-1240.�j� � a
oi age on the
ICOUNTY, S:
er ify
(
�
that•I, (We) was/were
Thaf I, (We) reside at
Township,
Indiana; that I, (We) have owned the following described
for 1(one) year or more prior to claiming this deduction, and That I, (We)
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 di
f.r.... oL.n..c
Legal Description or Key Number: �o �•�X i
�essed value of real estate or mobile home as of March
1,_current
� � MAY 0 5 1989 � �
Were„ either you or your spouse required to file an income tax return for the preceeding year? Yes
No '`� � If yes, a copy of such�e tu�rn-m tted for county auditor's inspection. .
��Qd-� sy�ou�receive an other deduction from ro ert tax7
Other than a Mortgage o, ontract De� c ion, o y p p y
�s' NO ave you filed application for •deduction in this County or any other county?
NO �
I swear under penalty of perjury that the above and foregoing information is true and correct.
'See False Statement Penalty Below. (On Receipt)
XlQ �� ��r._.e_8—d �•�. ) �j � ii_ Le i�%� ' rl� i9i,.o,..., .._' p 22. � 07.�..1
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