HomeMy WebLinkAboutAge_KriegAPPLICATION FOR SENIOR CITIZEN
. PROPERTY TAX BENEFITS
�Stl� Fortn d3708 (R9 / 9-OB)
� u, � preacnbed by ihe Departmem of Local Govemmem Finance
In(ormatiom m�tained in this doamenl is CONFIDENTIAL pursuant to IC 6-1.1-12-9 and IC 6-1.1-35-9.
COUNTY TOWNSHIP � YEAR
ile k
lNSTRUCT10N5: DEC 1 5 L��u
To be filed in persrn or by mail wrtfi the CourrtyAUdita ol the oounty where tl�e properfy is located.
Filing Dates: 7) Real Pioperty: Dunrg the tweNe (72) mmtAS before Decem6er 37 07 the year the deduction is to 6e efieclive/.�,F���
2) Mobile Hanes assessed urMei IL 67.7-7 ormanufectured hanes rrot assessed as reel proper(y.'�i��M0�91G9�12) months
be(ore March 31 ot the year fhe deduction is to be ef/active.
V
Seereverseside7oradddionelinsUUCtionsaiNqualifica6ons. GIBSON COUNTY AUDITOR
Type o( beneft reQUeped (please tlieck eC Naf appl�
/� Over 65 Deduction from Assessed Valuation �Over 65 Ciicuit Breaker Credit
Name o( apDl" (ownor a cmf+ac! DuyBr)
i
Is apoGwrtl the sde Iepal or eQUitade ameR It No, what his/nar exact share w interest? If owned with mmeone oihet lhan sDOUSe.
iMirate with whom
❑ Yes ❑ No
H name on record is difleraM ihan ihal of applirant, indicete 6ebw
Name d wMaG seAer (appficen( must ha�.e Oean buyinp m cmVacf at leasf orre (/J yeerj
Address of mntraC aeller (number and sbaet, city, sbte, aM ZIP mEe) �5 �he pmPer�y in Qu851bn:
�Real properry � MoDile home (IC 6-7-1-n
� 7�ci inct � Key number / Legal dascnption Record numher Page number
2b-11-1�- �o3-ovi�8i�-o
Is the properry used anC xwpaE primanly lor
Have you filad for a.ry o�her deductions? it Yas, what deductions?
�Yes ❑ No I . S .
Nava you filed tor deductiona in any other courrty7 �/!§s, wha� county?
� Yes ❑ No
UVJe certify under penaity of perjury that the above and foregoing in(ormation is tr�e and correct and that the appliwnt was a resident
of Indiana and owner of the aforementioned property on March 7, 20 _
Si�gnat/ura�dapWicar� AddressofaDPlifant (numOwandsGeel.ciy,sWfe.aMZ/Pmde)
� Signatura ot authoriz� sentative Addrass ot autt+wizad eao�asania�iva (n�mDer aM aboot, ciry, sfaro, antl LP codo)
l / / iv � � ,� �` `�/�.c.,2�_�c.�ox�