The URL can be used to link to this page

Home My WebLink AboutDisabilty_CanslerF�rcm IE6 Ilevl�ed 19iY • Prrurib�d hr ihr 91ntc ❑�nrd uf :na l;omm6elonen :. . � A1�PIllAV1'i' rOR 13LINll Olt ll1SA13L�ll PL1tSON'S llLllUC'1'lUN '1'U IIL I�ILIiD 1N I'liItSON Olt ItY p1AIL I;ACII 1'PAIt 1V177( Tlll�; � � COUN'1'Y AUllCPOR llli'C14'liLN nlAllCll 1 ANll 111AY t0, INCLUSIVli STA'1.'G OL'. lI�:DIANA PILING IN1�O1�I11A'1'lON ON 1SAC1C ..... COUNTY, SS: ,� , t �i i +� .....J�.�S�/...1'�1..Y..i....... � ... ... .... ..... being duly swoni, on alh s��yv Uu�l he ur shc ..........- - . . ��y�� <<t �l.W.�.....�..�(..�/�..��R.�-... .1�,<�m.e�.�r,�...�-.......... . � ... .. ................... lir.Ct ' � l 1 ./' l� � CiiLy Cioullty.. 1��' � Indi;inu; lhnt .� he or she is a dis•• �1ed11�eiaungasedefined i�� tl�e l�nd�iai 1�Code G-3-3-G�(u) (8) : t`c u��•ning re:�l esC.ile whicli ie used nud occupied principally for hia or her residence, und thnt his or lier lII%i!I)IC �;1'094 iucume (esclusive of auy income not tnxed uuQer the federal incouie t:ix l.iwy) is iiut in CXCI'89 UL �l,GUU for lhe inin�edintely preceding calendar year. '1'huC Lhis utlidavit is ivadc ioi• the piu•pose oS hiiving I:wo Lhousnnd ($Z,UOU) dollars �educled frum Chc i�sacss- ed ��.iluaLiou of 0 OWUIg escribed\t xnble piro erty for tlie y�eur 19.�.I., lu �vit : ............................................ ..� ...................�.�.. �.... .��.W ....��............�.-.�...-/...Q.......... ,.. �O. a.a.�....�....................,.......................... Lciug the applicant's principal residence pursuunt to IC -11-12-11 aud G-1.1-12-12. . . .. ......... . . ... �� -'c2��................................. ........ � � Applicant Sul�ycril�ed and s�yorn to before me tliis .........l..� ...... .......... day of ......�.4�,LL.C.�i.�., 1'J,_ .1..( C��.n�u�.�...-.�... �