HomeMy WebLinkAboutDisabilty_Ramsey� APPLtCATtON FOR BLIND OR DISABIED PERSON'S
,--• DEDUCTION FROM ASSESSED YALUATION
/ S ��! sra�eF«,,,esnotrmi�l
areesvv�ee Gy n�e DepaM�crt of Lxa� covmu,gnt F'.�e
Infirtnation contai�d in this doaiment is CONFIDENTIAL pursuant to IC Et.t-12-72@).
�I"'TRUCTIONS:
h7ed in person or 6y ma/7 wN� the CountyAudrTar of tl�e couniy wheie the poperty is located.
F"ding Dates.' 1) Real Property: Ouring (he year tor which the detluction is sought
2J Mobde Homas assessed underlC bf. i-7 or Manufactured Hwnes not assessed as Rea!
March 31 ot each year ihe ind�ividuel wishes to o6tain the deduction.
See reverse side fw additional inslructions and quafrfiratinns.
Name of appliran[ (owrrerorcontraC 6uye�
� 1 nrm . J/ �Ja'J7 � ol l
sde legai or ea��e �,�a � R No.
❑Yes ❑No �
tt reme on remrd is tlmetant Nan tlmt d�t 6tlhste
�:'� �•�P'T'�u�--.T.'_E7!rSi
MC`as^, W contract seller (rtum6er arM suaeG dry, stafe, eM LP wde)
appGCant ODrd as defined N IC 12-7-2.Z7(7J?
aY� uNo
h the propartY vaed er� ocwpiad P� fw hNha+ residerwe?
� Yes ❑ No
Key number / Lepal desrJipuan
rsf.�
AUG 2 3 P012
Pioperty Ouriag ttie Mahre (12J months before
T�R
I( owned wiM somerne otl�ar than spatse.
trtlirate vdth whan:
Is Ne property in question:
���Y � ���
AAo�le Hrnie QC 61.1-n
ls appCCant Gsaded aM unade m engage in anY ���� 4�W �Y
as tle0nea in IC 61.1-12-11(C)7
ooea n,e km,re taxaNa sra�+ v��me ra
ez�ed E7 .0007
��7 �
Remrtl numhel
Yes U No
aQ'ug cefandar year
❑Yes ❑No
UWe certity under penalty of perjury that the above and foregoing infortnation is Vue and correct and that the applicani was a resident
of Indiana and owner of the aforementioned property on March 1, 20 _
Srt�nanne af aPP�Mam
\ � �O�Y.��- �1J .
x
Atl0(ess of appiicarrt (num6eraM atrae4 �1: �e, aM Z1P crode)
�07 �. TreTf-en �'A�k Pr, F�$rnh�l,
Address af au4�d reWesentaCve (number erM abee4 �1: s�. enC ZfP rnde)