HomeMy WebLinkAboutDisabilty_Crow�' "'°v APPLICATION FO� DISABLED PERSON'S
�.
= DEDUCTION FRO SESSED VALUATION
� ;� -� State Form aa710 (Ra / to-Ot)
�' u: ' Preunbetl by Ne Department of Local Govemment Finance
COUNTY � TOWNSHIP YEAR
�mation contained in this document is CONFIDENTIAL pursuant to IC 12-7-7-t(n) and IC 6-1.1-12-12(b).
rRUCr�orvs: MAY
To be filed in person or by mail with the County Auditor o( the county where the property is located. 9 2��2
Filing Dafes: 1) Real Property: During the 12 months before May 11 0l the year the deduction is to be ective.
2) Mobile Homes assessed Lnder IC 6-1.7-7: Between January 15 and March 31 of the r�h, e���tio� to be ec 've.
See reverse side (or addrtional instructions and qualifications. ��BSON COUJJT y��nirX„
Name ot applicant (owner
name on recorC is ditter
ame of contracl seller
7dress of contrad seiler
applicant blind as defn�
the property used and c
what is Nsmer ezact snare m
❑ Yes ❑ No �
an that of applicant, indicate below
O1Yes ❑ No
❑ No
If owned with someone other than spouse,
indicate with whom
property
as defined in IC 61.7-12(d)?
Does the applicant's taxable gross
exceed 517,000?
il Property ❑ Mobile Home
engage in any substantial gain
❑ Yes ❑ No
Income for the preceding plen
❑ Yes ❑ No
fr1.
year
I/We ceRify under penalty of perjury that the above and foregoing information is true and wrred and that the applicant was a resi-
dent of Indiana and owner of the aforementioned property on March 1, 20 _
representative
of authorized reDresenWtive