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� °'° APPLICATION FOR BLIND OR DISABLED PERSON'S
��� DEDUCTION FROM ASSESSED VALUATION
�, State Fortn 43770 (R / 9-%)
S � PrescriEed by the SWte Board of Tart Commissioners
� 6 alion contained in this documeni is CONFIDEN7IAL pursuant ro IC 72-7-1-1(n) and IC 6-1.1-12-72(b).
INSTRUCTIONS FOR FILING:
To be liled in person or by mail with the Counry Auditor ol the county wheie the property is loca-
ted during the 12 months be%re May i l ol the year the deduction is to be effective.
See reverse side lor additional instructions and quali/ications.
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