HomeMy WebLinkAboutAge_Orrel"" v. AFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE, couNrr TOWNSHIP vEa,R
:�-- ;, REQUESTING DEDUCTION FROM ASSESSED VALUATION
�, Stale Form 43708 (R3 / 8-00)
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Prescribed by ihe State Board of Ta�c Commissioners
File Mark
1 � ation contained in this document is CONFIDENTIAL pursuant to IC Gt.1-12-9. �����
INSTRUCTIONS FOR FILING:
To be filed in person or by mail with the County Auditor of the county where the property is loca-
fed during the 12 months 6efore May 11 of the year the deducfion is to be effective. AP R 1 � 20��
Deductions for mo6ile homes not assessed as real property must file 6ehveen January 15 and
March 31.
See reverse side foradditional instruc5on and qualifications.
GIBSON COL'NTY AUDITOR
Name of applicant (owneror contract buyer)
Is applicant the sole legal or e itable owneR If No, what is his/her exact share or interest? If owned with someone other than spouse,
indicate with whom
es ❑ No
If name on record is diRerent than that of applicant, indipte below
Name of contract seller (applicant must have been buying on contract at /east one (1) year)
Address of contrad seller
Taxing dislrid Key number / Legal descriptlon Record number Page number
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Is the real property used and occupied Assessed value of the property as of March 1, current year (may not
primarity for his/her residence? exceed 569,000)
�Yes ❑ No
Was the applicant 65 years of age or more on December 31 of lhe year
Have you filed for any other deductions? If Yes, what deductions?
❑ Yes ❑ No
Have you filed for dedudions in any other coun[y? If Yes, what county?
❑ Yes ❑ No
I/We certi(y under penalty of perjury that the above and foregoing informalion is true and corred and that the applicant was a resi-
dent of Indiana and owner of the aforementioned property on March 1, 20 _
Signature of applicant Signature of authorized representalive (by executed Power ofAttomey)
�ess of appliwnt ��/' ��� Address of authorized representative
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