HomeMy WebLinkAboutDisabilty_Knight- r'.�.�� 166 Ilev�.vd 1978 ` ," �
I'm..criL�d by Ihe Sint< //�J��
IL.rtd a! 7'ea Cummiedenen _ � � I � �� ' / /
� AI�FIllAVIT I'Oli BLINll OR ll1SA13LLll PI.1tSON'S U1sUUC'1'IUN
'ro ur•, r•n.rn i� rrusoN o¢ �tv �tnn. ��;,�cn si;nic �rrru �rni;
couN��r nuurroe tzcrrve�tv mniccn � ntiu einr io, �NCi.us��•r:
FILIA'U 1NFOH(11A19pN UA` IiAC1C
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S'CA'1'E OP INDIANA .r� �`''U�'�".� _ COUId1'Y, SS:
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....����4'�✓��` ......... ... ... ...... .. ..... ........ ........................ being dulp s�cm n, on unth says thnl hc ur shc
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Strr.ct " - CitY � 1 Cuuuty - .
Lidianu; thut ^�'" or shc is a blind per;ou (as deCined in Lhc Indinua CuJe I'L-1-1-L(o) )
�y ,�e or she ia a diaaLled ��ersuu as defined in thc lndiaua Codc G-3-3-G (.i) (8) :
u�euiny rcal esLate whicti ie used nnd occupied principally for his or her resiJence, and LhaL liis m� hm- taz:ible �;ross
incume (exclusive of any income not taxed under the fecl.e!:�! incume taz la��s) is uut in excesy ut y7,5UU for Uie
immedintely preceding calendar year.
'1'hat this affidavit is made for the purpose ot h.�ving t���o iLousaud (y1,000) dull;irs deducLcJ fcom Lhe asscss-
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�i1�uLi n of the following de ib d axnble propecty fur the yeeu� 19..__..., lo �cit:�,J\J��.�CC�!,.
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bcing the applica�it's principal reside�ice pursuunt to 1C G1.1- 2-11 and G-1.
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Subscri�ed�8nd sworn to befoie me this ......�...-\.�...._......_ day of ...
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.2�,�f� �n�.�-s roiz nulirruit�s usL
auD�ro�
'Cutul A ses ed Value of Taxable Property for year 19��....
l�/.��\�,.�"�!�!..- --`^�,. C.`.1 ................................. 1'o«•nship, l:ail listaile .;,.........._....._..........,
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A.sessed in Lhe name of .,\�\!'2�.-��-, \.._.... _... k�-.�J. -.......�^c-"`{�`!�,-...._...
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Amount of Taxable Yroperty lleducted ,S `et ••ilue of '1'•ir•i�le 1'roperly $�{
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Filed .... . . ....... ._�� 12. .���.. C t-�9� - - � �
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� nuditur ��,
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