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� AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE, couNTV TOWNSHIP rEn,rt
REQUESTING DEDUCTION FROM ASSESSED VALUATION
S,«� � Sfate Fwm 43708 (RS / 6-03)
PiasuiEetl Dy Ne Departmem of Local Govemment Finance
Infortnation contained in this document is CONFIDENTIAI pursuant to IC 61.1•12-9.
�RUCTIONS:
To be filed in person or by mail with the County Auditor o/ the county where
the property is Ixated.
See reverse side )or additional instruction and qualificafions.
T F�e.Marlc�
� ' II � � \p`�
FILING DAFES: � 1U IL%
1) Real property Dtr�ing the (,�o,nths 6efo2 May
11 of the year�llie de'tlucti tk�o be effective.
2) Mobile-homes assessed under I.C.6-1-1-7;
betweeh January�5 and�March 31 o/the year
the ded"uction is-M'be effective�
" GI3SON COUNTY AUnrinF I