HomeMy WebLinkAboutAge_TeetersAPPLICATION FOR SENIOR CITIZEN courm TOWNSHIP r�x
: - . PROPERTY TAX BENEFITS
� y '"' Stale Form 43708 (R9 / 9-0B)
Prescribed by Na DepartmeM of Laal Govammerit Finance
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Infortnatiom m�fained in this tloaiment is CONFIDENTIAL pursuan[ to IC G7.1-12-9 and IC 61.135-9.
INSTRUCTIONS: q c�
To be filed in person or by mail with Iha CountyAuditor of fhe county where the properiy is laca(ed. � U N `!� �Q � Z
Filing Pates: 1 J Real Property: Dunig fhe fweNe (72) mmths 6e/ore December 31 07 tlie year the deduttion!i�s Mto 6e efiective.
2) Mo6i/e Hanes assesser/ under IC 61.1-7 0� manulactured hwnes irot assessed as real �perry.'�,\@ AveNa (72) monfhs
be/ore Martir 31 0/ the year the detluction is to 6e eflective. V v
Seereversesdeforatltlitionalinswclionsandquali6ca6ons. GIBSON COUNTY AUDITOR
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Type d heneN requested (please rheck a0 Nat apply)
� Over 65 Deduction from Assessed Valuation ❑ Over 65 Circuit Breaker Credif
Name ot appli�nl (ownor or co^nhaG buyeQ
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Is appfimrit tha sde lepal or equitable o.mer/ H No, what is hisiher exact shara w inierasiT It awned with mmeone ather Nan spouse.
inditate wiih whom
Yes ❑ No
1( �me on `emd is d'Marent ihan that ol apWicant ��dirata bebw
Name d contrs^d se^0er ( nt must hare Ooen buyirg m cantract at Irast orm (1J yea�
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Address d mntratl mller numbei aM strea4 uty, sfate, a�d LP mCe) Is lhe PmPeity in 9uestion:
Y V Real pmperty � Mobile home (IC 61-1-n
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Taxin disirict Key number / Legal tlesuiption Record number Page numbar
aCP- /d-/7-/0%fX7a-
Is e praperry useE antl orcupied primarity lor Assessed vaNe ol ihe p(vperry az of Marrh 1, curteM year (may mf earaeE SiH2,430
ItisThar residen�i !o� U.er 65 tletludim, v E160,000 Porfhe Oimf 65 Circut Broal�r CradiQ
�Yes ❑ No
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N4s tha appfxarit 65 years o( age or rtmre on Oacember 37 of the year
Hava you filed (or any Wher detlucUOns7 IF 1§s, whal dedurborts?
� Yes � No
Hava you filed (ar datluctions in any ahar counry7 Ii Ves. wha� mumyt
� YES O
IlWe certify under penalty of peryury lhat tha above and foregoing information is We and wrrect and that the applicant was a residenl
of Indiana and owner of the aforementioned property on March 1, 20
Signatura dappG�aM Addrass of apo�nt (nvnboraM sboel, dty, stab, aid Z/P wde)
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ignnure d aulhortzed ra0�eritative Address of auitwrized rapresentative (nwnberarH slloof. cify, sfate. anCTJP coCO)