HomeMy WebLinkAboutAge_RedmanAFFIDAVIT OF PERSON, 65 YEARS OF AGE OR MORE, cour+n TOWNSHIP rEaa
REQUESTING DEDUCTION FROM ASSESSED VALUATION
S�w > State Form 43708 (R7 / 5-06)
� Presrnbed by the Departrnent of Loral Govemment Finance
Fi M
Information wntained in ihis document is CONFIDENTIAL pursuant to IC 6-1.1-12-9 and IC 61.135-9
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor oI the county where
the property is located.
See reverse side for additional instruction and qualifications.
apptipnt thA sole I urt:
/
name on record is iNerent than
of tontract
and ocapied
❑No
musf have been 6uying on
the applkxnt 65 years of age w rtrore on
to the current year?
IT filed by a
the time of
you filed for any other
day, yearJ
spouse,
you filed for deductions in any othef
share w
one (7) year)
number I Legal desaiptlon
December.31 ot ihe year
�Yes ❑No
was ihe spouse's age at
❑Yes ❑No
FILING DA��O 2 ZOo7
1) Real prope . Dunng the 12 months before June
11 of th r the hon is to 6e eftective.
2)Mo6ile o ��_��J underl.C.6-1-7-7;
b��1��n,0E(Yf����l�h 31 of the year
the deduction is to be effective.
If owned wiM someone other than spouse,
i�irate with whom
property in question: -
❑Real property Q Mobile home (I.C. 6-7-1-�
Record number Pagenumber
�d value of ihe property as of March 1, wrreM year (may not
S14a.000)
e combined annual adjusted gross income ot Ne appiinrrt and any
als sharing uvmership exceed 525,000?
Yes, what county?
of Income
$
$
TOTAL $
❑Yes ❑No
Amount oi Income
❑Yes ❑No I
IIVJe certify under penalty of perjury that the above and foregoing info��r��n is true and correct and that the applicant was a resident
of Indiana and owner of ihe aforementioned property on March 1, 20 _
qnaNre of appiicant Signature of authorized representaWe (by ezecufed PowerWAttomey)
representalive