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Disabilty_Redford. ,. ' "°' APPLICATION FOR BLIND OR DISABLED PERSON'S counm TOWNSHIP rean — - DEDUCTION FROM ASSESSED VALUATION saee F«m a3>>o �a� i s m� ��'w• � Prescnbed bY Ihe DeVMmaN d Loml Gmemmenl F(ance nfortnation owitained in Ihis doaiment is CONFIOENTIAL purwan� to IC 6-1.7-12-72(b). F INSTRUCTIONS: roear,rea��rs«,a.ay�a,.:u,u,aco,evyn�aao.o,maoo�tywn�ma�y;��raa. JUL 1 2 2010 Filiry Dales: iJ Real Property: Ounng Ne year la whki+ the deduction is mught 2) Mobile Homes assessed under IC 6-7.1-7 or Manuhdctured Homes rwt assessetl as Real R[ipeer(y: Dunrg lhe MreNe (72J montlrs belore March 3 f d ead� year Me individual wishes to obtain fhe tleduction. `—y�.� i See reve�se sde7oradddional insWdmns arnl Nama N zPW�rit (ox�rt:/ ar conhact 6uYeO Ls appfioN Na stle legal or rc �ume on remd is dilfarenl than a'"'i1L.e�T.r�� '�'es ❑ No I d appFranl iMirate Calwr. Pddrass d mntrad seGer (mmber arb sbee�. ciN• sfab. and LP oo�) � aoa��m �rro � aer�m �n ic i2-i-2-2i1i�? Yes U No Is Lhe MoPaM useC aM occvO�eE OMa^�Y br hrslhar revCerice7 ❑ No Key numbeN d mteresl? � C oYVneE �tilh somaona uqimle wM wM�rt �m � a�� PropertY ❑ MruiaOYlissessed lAohde Fiane (IC G7.1-7) Is applimnt disableE and unade to engaga in arry wbslarrtial gain(ul adiviry as definad in IC &1.7-72-07(d)? �es ❑ No Dces Ihe aPO�b'S la+ade 9ross imm�e fof the esmeE 517,000? ❑ Yes �No Remrd number Page number IIWe ceAify under penalty oi perjury thaf lhe above and foregoing informa6on is We and correct and that the appiicant was a resident of Indiana and owner of lhe aforementioned property on March 1, 20 Addrass of apphaM (imnber aM sbeet, riry, sta�, aM ot aufhorized repraserilative' (V�ivnEO! aM sWet. city. 5aro. antl ZIP co0e)