HomeMy WebLinkAboutDisabilty_Garretti � �;
i "" APPLICATION FOR BLIND OR DISABLED PERSON'S
,� !; DEDUCTION FROM ASSESSED VALUATION
�Sute Fortn 43770 (R / 9-96)
' � PresaiEeE by Ne State Board of Tax Commiuioners
In�aSon contained in this document is CONFIDENTIAL pursuant to IC 12-1-1-7(n) and IC 6-1.1-12-12(b).
INSTRUCTIONS FOR FIUNG:
To be liled in person or by mail with the CountyAuditor o/ the county where the property is loca-
ted during the 72 months be%re May 17 0l the year the deduction is to be eNective.
See reverse side lor additional instructions and qualifications.
Is applicant tFe sole legal or
If name on record is diflerert
Name oi contract selier
4ddress of contract seller
I5 applicant blind as defined
s Ne properry used and occ
f� districl
/(S\ \ � n
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;r? It No,
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
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VV � � l. � C
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COUNTY TOWNSHIP YEAR
_w �
� File Mark
APR 2 0 1999
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G�BSON CtiU:�TY .4UDI703
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❑ Yes
spouse,
❑ No
year
I/We certify under penalty of perjury that the above and foregoing iniormation is true and correct and ihat the applicant was a resi-
dent o( Indiana and owner'of the aforementioned property on March 1, 19 _
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