HomeMy WebLinkAboutDisabilty_Manning--� APPLICATION FOR BLIND OR DISABLED PERSON'S couNrv TOWNSHIP
��, DEDUCTION FROM ASSESSED VALUATION
S1ate Fortn d3710 (R7 / � )
� � Resaibcd bY �e Deparimrsl d Lo[al Gwemrt�¢nt Fina�xe ''��ll
1 n(ormation contained in this dxument is CONFIDENTIAL pursuant to IC 724-�a IC L1-1 1( �.
�NSTRUCTIONS: � �
To be filed in person or by mail wifn Ihe County Auditor ot lhe county where the property is IR�j�(ed.
Filing Dales: 7) Real Property: Dunng lhe 12 months befo�e June 11 0) fhe ye� '7� d�dbct%d�i� lo be
2J Mobile Homes assessed under IC 6-7. 7-7: During the 12 monlhs before March 2 o/e
obfain the deduction. �� /1�
N
See reverse side for additional instructions and Qualifications
INameofaqpixant(ownerorwnvactbuyer) � G�gSONCOU
� � �
Is ap iwnt the sole legal or equitable owner? le�9fihat is
hll'e5 ❑ �
If name on record is diRerent Nan that of appiiwnt, indicate below
Name of contraa seller
Address of contract seiler
as defined in IC 12-1-1-1(n) antl IC 6-7.
❑ Yes ❑ No
Ihe property used and ocwpied primanly (or his
❑ Yes ❑ No
�ci`gdistrict� /� ,
`�J �/
/X/—/
residence?
Key
exact share of interest?
applicanl c
defined in
owned
vEna
the individual wishes
other than spouse,
Is 1he property in question:
�❑ Real Property ❑ Mobile H
�d and unable lo engage in any substantlal
1.1-12-17(d)? �
6-1.1
es ❑ No
taxable gross income for Ne preceding calendar year
❑ Yes BfJo
Record number Page number
I/We certify under penalty of perjury that the above and foregoing infortnation is true and correct and that Ihe applicant was a resident
of Indiana and owner of the aforementioned property on March 1, 20 _
represen�alive
\ �� � IAddress of authorized representative _
` /J/ Y 1 .