Age_Strickland- APPLICATION FOR SENIOR CRIZEN courm Towns�nr r�
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bCametM oontelnad 4� ttus doartnem a CONFIOENTIAI pusuant m IC 61.1-12-8 a�d IC 61.135-9.
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aeroreMe�nsioimeme��ad�ew��,ronoaeoaroo. 616SON COUNTY P.UDITOR
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� Yes ❑ No
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❑ Yes � No
IIWe certity under penalry of perjury thal We above and foregoing information is We and cortect antl Nat tlie applicant was a resitlent
of Indiana and awner of the aforemen0oned propeny on March 1, 20 _
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