HomeMy WebLinkAboutAge_ThompsonAPPLICATION FOR SENIOR CITIZEN couNn TOWNSHIP � YEAR
� PROPERTY TAX BENEFITS
_ �! Stale Fartn 43�08 (R9 / 408) �
� u Prascnhed 6y �he DeoaRmer.t ol Local Govammem Finance �L
Fi e ark��
Infortnation containetl in this doament is CONFIDENT�AL pursuaN to iC 6�1.7-12-9 ane IC 6-7.7-]5-9.
E� 3 1 2008
� 1NS7RUCTIONS:
To 6e filetl in persm or by meil with the CountyAuCifor o/the county where Ihe properly is located. •
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Filirrg Dafes: 1) Reel Property: Dunng the tweNe (72) months before December 31 07 fhe year Ihe tleducu(;ryr is� tAo� 6e e�icG .��-.;
2) Mo6ile Hanes assessed under IC 6-7.7-7 or manulactured homes nol assessed as real pr�o�ery F6A"�Jg.fv�9'T�2J monfhs
� be/we March 37 07 the year the deducfion is to be eflective. � �
See reverse side (wadditionel lnsWUions alM qualificafions.
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Type d banefd �epue5 (Woeso d+ock a➢Naf apply)
Over 65 Deduction 6om Assessed Valuation Over 65 Circuit Breaker Credit
Neme apD�rc{nl(wrtaraconf2clDUyah
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Is applimM t a lepal or epuitaWa oxne(7 No, wha s �islner azacf hare or in�erasl0 If ownaE with wmeone olher Ihan spouse.
indicala wilh whom
Yes ❑ No
II nema on �ecofd is differanl Nan tlut ol aDd��l ��diwte bebw
Nartre ot cont2G eaAer (eppllcan( mus( have been Ouying on conf2c( af lea4 0� (1) ycaQ
Pddress ot contrad salier (numDeiaM sbeet, city, stato, and ZIP codo) � Is �he property i^ QuB5fi0n:
� Real property ❑ Mobile home QC 6-7-7-�
ITazi Ci lnct Ka n mber! le9al tlescriotion � Record numSer Page r.umoer
�GS�a�/o3Q�O, 3gG-�a
Is Ihe praperry useE and occupad pnn+ady br 0.sseued value of Ibe orooeny as of Marcli 1, curtenl year (may not erceed 5182.<70
his/ner rasidenm7 (or Owr 65 dotl�fJion, w S iG0.000/or:AO Ovor 65 C'vcuit &cakcr Credi�
Yes ❑ No
Was ihe applicam 65 yaan ol aga w more on Oacember 31 0l tne year
Have you filad for any olher deductions7 �� �'es. whal deductior.s? � :
�Yes ❑No ��
Have you fdad for CeEUCUOns in any Ghar counry7 I II Yes. whal wunty?
❑ Yes ❑ No
I/We certify under penalty of perjury that the above and foregoing information is We and correct and that the applicant was a resident
of Indiana and owner of the aforemenlioned property on March 7, 20 _ .
gnaW apd��� Cress of appfimnt (numLwantl s�mc1, ci.y. s�atc. and ZIP co0c)
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Signatura W e �zed rapresentativa Mdress authorized reoresenlahve (numberand slreet, city, StaM, an0 ZIP code)
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