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APPLICATION FOR BLIND OR DISABLED PERSON'S
DEDUCTION FROM ASSESSED VALUATION
State Form 43770 (RS / 6-03)
PrescriDed by the Department of Local Govemment Fciance
COUNTY TOWNSHIP YEAR
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Inf�rtnaUon contained in this document is CONFIDENTIAL pursuant to IC 12-7-1-1(n) and IC 6-1.1-12-12 bj. i e a
�eucrioNS: A�'� 2 9 2004
.,e filed in person or by mail with the County Auditor o/ fhe county where the property is located.
Filing Dates: 1 J Real Property: Dudng the 12 months 6efore Mey 11 of the year the deduction•is to+be e� ctive ��
2) Mobile Homes assessed under IC 6-1.1-7: During the 12 months before'March'2�ot each'year the individual wishes to
obtain the deduction. �' GI9SON GOUNT'f nUuil'_ .. •