Age_Berry APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
i -::;-• 1 PROPERTY TAX BENEFITS n
State Form 43708(R19/7-25) 0, losD)
Prescribed by the Department of Local Government Finance
Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-35-9.
Instruction's: To be filed in person or by mail with the county auditor of the county where the property is located.
Filing Date: Form must be completed,signed,and filed with the county auditor or postmarked by January 15 of the calendar year in
which the property taxes are first due and payable.
See reverse side for additional instructions and qualifications. ? .
Type of Benefit Requested(Please check all that apply)
a6c/er 65 Credit acer 65 Circuit Breaker Credit
Name of Applicant(owner or contract buyer)
Owned with Joint Tenant or Tenant in Common,Indicate with Whom
es 0 No
If Name on Record is Different than Applicant,Indicate Below , Do All Joint Tenants or Tenants in Common Reside on the Property?
EK; 0 No
Name of Contract Seller Has Applicant Owned or Bought the Property Under Recorded Contract
for at Least One(1)Year before Claiminj_CrepP.•
P\ WY-es El No
Address of Contract Seller(number and street,city,state,and ZIP code) Is the Property in Question:
11114;Property 1:3 Mobile Home(IC 6-1.1-7)
T xing District a) Key Number/Legal Description Record Number Page Number
ak (2 -9L-A -a(- - )0-o,00 ./05-oo
.
Did Applicant qualify for the homestead standard deduction in the preceding year(or was applicant married at the time of death to
a deceased spouse who qualified for a homestead standard deduction for the individuals homestead property in the immediately Ees El No
preceding calendar year)and does Applicant qualify for the homestead standard deduction in the current year?
Is the Applicant 65 Years of Age or More on December 31 of the Year Prior to the Year Taxes are First Due&Payable? IIK: 0 No
\— \— •
Signature of App Date(montll,day,fjLED
...v 1/4-1 ,, i ( g
Address of Applicant(number and street,city,stat and ZIP code)
1Q t•-. . c,.1,,A- V_.
, c--)( i-o-kult„._ AUG 18 2025
Signature of Authorized Representative ) Date(month,day,year)
Address of Authorized Representative(number and street,city,state,and ZIP code) Al-C114e. a pizth;,24)
GIBSON COUNTY AUDITOR
Signature of County Auditor Date(month,day, ear) •
t_.(- ,uo_if_ .- a_R_A ft . .),Dci_3--\L-uvuDi g .. - -- ..
_
DISTRIBUTION: Original—County Auditor;File-Stamped Copy—Taxpayer
'`�
authorized represeniative