Disabilty_Morris's � �,
APPLICATION FOR BLIND OR DISABLED PERSON'S
DEDUCTION FROM ASSESSED VALUATION
State Form a3710 (R9 / 9-OB)
PrestYibeE by Ne Departmeni of Local Govemment Fnance
�atlon contained in this document is CONFIDENTIAL pursuant to IC 61.7-72-12(b).
INSTRUCTIONS:
.�-�-. . ;
COUNTY TOWNSHIP YEAR
�I� � � �P��
JUN 1 2F��0��`
To be �led in person or by mail with fhe County Auditor o/ fhe oounty where the property is located.
Fding Dafes: 7) Real Property During the year lor whifh the deducfion is so ht.
�9 �6� �
2) Mobile Homes assessed under IC 6-7.1-7 or Manulactured Homes not assessed as Real Property: Du6r(g the Ive/ months be(ore
March 31 0l each year the individual wishes to o6tain the deduction, pIBSON COUNTY AUDIT�
See reverse side /or add'rtional instruclions and qualifica(ions.
Name ot app6ram (owrrer w contrsa buye� '
Rebecca R Morris
Is ao06ca�t �he sde kgal w eQUitada owne(.� tt No, what is his/her eYaG share d interesl? It ownetl wiTh sdneone othu Ihan sDODU.
indicate wiih whan:
�X Yes ❑ No
II name on record is tlMerent Ihan that ol applipnt, indiqte below:
Name a oon;ract se�ei
AEdress of mntracl se0er (number a� slreet, dry, sfate, arM ZIP code) Is Ne property in Questim:
� RealPropertr ❑ fw,uaMnss�ssed
Mob�e Hmie (IC 61.1-7)
Is applinnt di� as defined in IC 12-7-2-27�7)? Is appGfan� tlisabled a�W unada m engage in any substantial gainfid adivi
as defineE in IC E7.7-72-11(E)? h
❑ Yes ❑ No- XQ�Yes ❑ No
Is 1he properly used end ocapieE prirtiarity (or hisrher residence? Does Me applicanYS tazahle g�oss income (or Ne preceding calrndar yPar
eaceetl $77.0007
� 0 Yes ❑ No ❑ Yes X� No
TarinytlistriU Ke num6er/Legal�desaip4on Recor�numCer Pagenumber
� -�� � •�300 -m/.5 y y- a /
enoncyo�r�ery oos-o, r sw 2s z„ 2.z�s2 nc
IlWe certity under penalty of perjury that the above�and foregoing�infortnation is true�and cortect and that the�applicant was a resident
of Indiana and owner of the aforemen[ioned property on March 1, 20
Signat lapplicant AdAressofapplirant(numberaMstreet,rily,sfate,andZlPmde)
� 3272 S�525 W, Owensvllle , IN 47665 ,
re of a ed re' ta ' AdNess o( auUwrized re�esentative (number aM stree4 ciry, state. and LP code)