Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
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)