Disabilty_AdamsI
I1
.. ��.M APPLICATION FOR BLIND OR DiSABLED PERSON'S
.� DEDUCTION FROM ASSESSED VALUATION
Sute Fortn 43710 (R / 9-96)
i��k � PrescriDed Oy Ne State Boartl of Taz Commissioners
ation contained in this document is CONFIDENTIAL pursuant to IC 12-1-1-t (n) and IC 6-7.1
INSTRUCTIONS FOR FILINC3:
COUNTY TOWNSNIP YEAR
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To be liled in person cr by mail with the Counry Auditor ol the county where the property is loca-
ted during the 72 months beloie May 17 of the year the deduction is ro be eHective. �'�Y � Q )Q�Q
See ieverse side lor additional instructions and quali(ications.