HomeMy WebLinkAboutAge_RiggF�� 3D PevisN t980 AFFIDAVIT OF PERSON� 65 YEARS OF AGE OR MORE
PeacnDeC q �ne Sta:e
eoam o� ra. cammus+«iers REQUESTING PROPERTY TAX DEDUCTION
TO BE FILED IN PEHSON OR BY MAII EACH YEAR WITM TME
' � COUNTY AUDITOR WHERE OWNEH'S VFOPEFTY IS LOCATED:
NEAL PflOPEflTY - BETWEEN MARLN 1 AND MAY 10, INCLUSIVE
MOBILE HOME - BETWEEN JANU/RY t AND MAPCM ]t, INCLUSIVE 0���'
� ' (NOT ASSESSED AS REAL PFOPEFTY�
(61.142-9 AND 61.14140.1)
STATE OF INDIANA, ..C���U�J` \ COUNTY. SS:
—�I . . • .n '
I, (We) � � ,
��_. That I, (We) reside at
�STREET OR FURAL ROIAE� � OWN) ' � G'��•�� Township,
' County, Indiana; that I, (We) have owned the following described
real estate
for 1(one) year or more prior to claiming this deduction, and That I, (We)
❑ mobile home
now reside in the premises for which this deduction is claimed:
Survivin��u��tion is being made by a surviving unremarried spouse:
pouse s age at time of death:
Name on hp�' e�y4 taz�.records if different from above:
Legal �g�ji� dyy��mber: �/W�iZT l�
AUDITOR
�sessed value of real estate or mobile home as of March 1
� _.
current year: � � '� � 7 �(„�
Were either you or your spouse required to file an income tax return for the preceeding year? Yes �
No If yes, a cop of s ch retum must be submitted for county auditor's inspection.
Other than a Mortgage r ntract Deduction, do you receive any other deduction from property tax?
s NO Have you filed application for deduction in this County or any other county?
NO
I swear under penalty of perjury that the above and foregoing information is true�and correct.
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