HomeMy WebLinkAboutAge_HoeflingF APPLICATION FOR SENIOR CITIZEN r r�
PROPERTYTAX BENEFITS
Stale Form 43708 (R9l 408)
� ••+�j�C� PrescnbeE bY �ha DaGa�er�t of Local GovemmaM Fina(rca
� Infwrtiation wntainetl in Nis tloament is CONFIDENTIAL pursuant to IC Cs1.1-12-9 and IC 6-1.b3S9. I��
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wsrnucnoNS:
To be filed in person or by marl with the CountyAudAa olthe county where fhe property is located. t�
Filing Dates: 1) Real Property: Dunng the tweAre (72) mmths be(ore Decem6er 31 o/fhe year the tleductiott ��h�Q�e�T�c6i�.TY AUDITOR
2) Mobile Homes assessed urrder IC bf. i-7 or manu/actured hanes rrot assessed as real property: Dunrg fhe hve/ve (12J months
be/ore Marrh 37 of Ihe year the deduction is lo be eRective.
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See reverse side 7or adtliliona/ inshudions and qualifications.
Type d heneEt reQUasied (p/ease Merh a0 Nat aPply)
�Over 65 Deduction from Assessed Valuation �Over 65 Circuit Breakar Credit
Namea(ap " rtl(awnerorcanfracfWyerf ,
Is applicaM the sde legal or eQUitable ormeR tt No, what is his ezad share w interasl7 If owned wilh someone athar lhan spouse,
iMirate wiN whom
❑ Yes ❑ No
If name on remd is dilfereM Ihan thal d appLrant ���e bebw
Name d m�aa sener (applcant must nave 5een bvyiny m cmbac+af roast orre (f) year)
ACdrass of mntrad seller (numboiai0 sbaet, cify, slafe, aM ZIPmE¢) �s the properry in quastion:
� Real pmperty � Mobile homa (IC 674-n
Ta`ving �d' ' Key number I Legal descriplion Record numhar Page numbar
� 7 a� � 2�-�`f z�l� 30
�- 000. Y�.3- a.o
Lv Ihe pmperty u5ed arW occupied ptimanly (or Assessed value ot ihe qope�ty as ot March 7, cuRant year (may iml excee05182,430
his,har residenm? lor O�er 65 ded�Cim, o-S760,000 !oi No 0.er 65 Circuil BroakerCrediQ
❑ Yes ❑ No
VJas ihe app6mm 65 yean ot aga w rtrora on Decamber 37 af lhe year
Have you filed tor am/ ot�er deductions? H Ws. whal dedud'mrts?
�Yes ❑ No �.,5.
Hava you filed (or deduc0ore in any other murrty? If 14s, what cou�?
❑ Yes ❑ No
VWe ceAify under penalty of peryury that the above and foregoing information is lrue and conect and that the applicant was a resident
of Indiana and owner of the aforementioned property on March 1, 20
Signatura d applkant Address ot appGrant (nirtn6orantl sboeL �}: sfate, aMZlPCOde)
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Signature d author¢etl represe We /dtlress of aulhwized rapresentative (num6e`antl sfree4 aty, stata. andLP cado)