Disabilty_Dillon.�°"°'" APPLICATION FOR BLIND OR DISABIED PERSON'S � courrrv TOWNSNIP vEna �
� DEDUCTION FROM ASSESSED VALUATION O ;
� State Form 43770 (R / 9-96) q.��
�' � PreSCribed by Ihe SUte Board o( Tax Commissioners
V
.�...ortnation coniained in this document is CONFIDENTIAL pursuani to IC 72-1-1-7 (n) and IC 6-7.1-12-12(b). File Mark
INSTRUCTIONS FOR FILING:
To be liled in person cr by mail with the County Auditor o/ the county where the property is loca-
fed during the 72 months be%re May 77 of the year the deduction is to be eflective.
See reverse side (or additional insVuctions and qualilications.