HomeMy WebLinkAboutAge_Wright (5)� AFFIDAVIT OF PERSON� 65 YEARS OF AGE OR MORE� COUNTY TOWNSHIP vEAR
?- 4 REQUESTING DEDUCTION PROM ASSESSED VALUATION
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SUIe Fortn 43708 (R3 / &OO)
�'•'• � Prescribed by Ne State BoarE o(Tax Commissioners � �{ 1�� .T"'1
rmation contained in fhis dowment is CONFIDENTIAL pursuant to IC 6-1.1-12-9. �� File M'9flf �
j{ i
INSTRUCTIONS FOR FILING: M�Y O 5 Z003
To be frled in person or by mail with the County Auditor of the county where the property is loca-
ted during the 12 months be(ore May 11 of the year the deduction is to be e(fective. ///� /
Deductions (or mobile homes not assessed as real properfy must file 6etween January 15 and �, /�, �{ J��1%
.., � v�.,
March 31. �� GIBSON COL'NTY :.Up17pR
See reverse side lor additional instruc6on and qualifica6ons.
or
If name on reco�d is diRerent
Name of contrad
primarily for liislher residence?
� �-/�l..i �-f \ �
share or inter 7 If owned with someone
. indicate with whom
Y�s ❑ No I
that of appiicanl, indicate below
musf have been buying on contract at least one (1J yea�
the applicant 65 years of age or more on
to the wrrent yeart
date
the spouse's age at
any other deductions?
❑ Yes �lo
deductions in any other county?
❑ Yes p�pto
$
INVe certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant was a resi-
denl of Indiana and owner of the aforementioned property on March 1, 20 _
�- �7(0 7 C�