HomeMy WebLinkAboutDisabilty_Brown�""'"a APPLICATION FOR BLIND OR DISABLED PERSON'S COUNTV TOWNSHIP � YEAR
- : DEDUCTION FROM ASSESSED VALUATION
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�� .� State Form a3�7o (fia i io-oi�
S•� : "f Presmhed by the Department of Local Govemment Finance -� — �� � � '� � � �� �° �
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�'^°�mation wntained in ihis document is CONFIDENTIAL pursuant to IC 12-1-1-1(n) and IC 6-7.1-12-72(b)� ���le M� �
RUCTIONS: �Y
o be filed in person o� 6y mail with the County Auditor of the county where the pioperty is located � �� % 4 Z��3
Filing Dates: 1) Real Property: During the 12 months be%re May 11 of the yearthe deduction is to be e ec�ive.
2) Mobile Homes assessedLnder IC 6-1.1-7: Between January 15 and March 31,af•the year the deduc6on is to tie eNective.
See reverse side fo� addit
Name of applica w er oi
Is applicant the sole legal or
If name on record is d'rflerert
I Name of contyact se er
instnictions and qualifications.
acr buyer)
� �
able owneR If
5 ❑ No
at of appliwnt, indicate below
of contfa�t seller
3nt blind as defined in IC 12-1-1-1(n) and
❑ Yes �
iperty used and occupied primarily fo his
Yes ❑
_
ir�f appi� �' �', �
�
of applicant �
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