HomeMy WebLinkAboutDisabilty_Skelton`°"' s APPLICATION FOR BLIND OR DISABLED PERSON'S
— �, DEDUCTION FROM ASSESSED VALUATION
State Fortn 43710 (RS / 6-03)
•� �« � PresrnOed by the Departmeni of Loral Govemment Finance
COUNTY
'� � File Mark
Infortna[ion contained in Ihis document is CONFIDENTIAL pursuant to IC 12-1-1-1(n) and IC 67.1-12-12(b �
�UCTIONS:
�led in person or by mail with the County Auditor o/ the county where the property is located.
Filing Dates: 1) Real Property: During the 12 months before May 11 ot the year the deduction is tq�� glfective.
2) Mobile Homes assessed under IC 6-1.1-7: During the 12 months 6e/ore March 2 of each•year (ti§Qn�iividual wishes to
obtain the deducfion. / �
See reverse side for additional instn�ctions and ualificafions. ��. �--� � _
�Name of applicant (owner�Q/lpntract buyer) y ,���n �— � C�aSON COUA'7 Y��r/_
i �
name on
equitabie owneR If No, what is
es O No
'. than that ot appliwnt, indiwte below
Name of wntract seller
Address of conVaG seiler
Is applicant blind as defined in IC 12-1-1-7(n) and
❑ Yes ❑ No
Is the property used and oxupied primarily i<
s ❑ No
Tazmg district
I/We certify under
of Indiana and ow,
of
3
wiih someone other than spouse,
with whom
Is the properry in quesUon:
❑ Reat Property ❑ Mobile Ho�QC E1.
3ble to engage in any suhs I gainful acfivi
as defined in IC 6-1.1-12(d)?
Dces the applicanYs taxabte gross income fo
exceed $17,000?
�tion Record number
�S ❑ No
preceding cal
❑ Yes
' perjury that the above and foregoing information is true and correct and that ihe applicant was a resident
aforementioned property on March 1, 20 _
of auNorized
represenWtive
N