HomeMy WebLinkAboutDisabilty_SpindlerL'„rtn 156 Nevised 1979 �'
Pr.-x:iqa' br Ne State ' � "
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� AFFIDAVIT FOft BLIND OR DISABLED PERSON'S DEDUCTION
TO BE FILED�IN PERSON OR BY MAII. EACH YEAR WITH THE
. COUNTY AUDITOR BETWEEN MARCH 1 AND MAY 10, INCLUSIVE �
FILING INFORMATION ON SACK
�
" ' ��o-IS'�lot� 660 �� � - Ga�
STATE OF IA'DIANA ......1 .. .. ........ COUNTY, SS: '
-.....C��J-�,�tZ...... .T...•..... .... -------- .............................................. being duly sworn, on oath says that he or shz
l! =� /��� /��,���� �,(�� ��
re,ides at ... �...�_ �...._L��K...�Si.......... '�'�-:_r. -_ "'"- - - -� �--- � �"-"-' `-' "�
Strcet �. City � County ,
Indiana;thut � he or she is a blind person (as defined in the Indiana Code 12-1-1-1-(0) )
j� he or she is a �.sabled person as defined in the Indiana Code 6-3-3-6 (a) (8):-
o«�ning real estate whicfi is used aud occupied principally for his or her residence, and that his or her ta�;able gross
income (exclusive of any income not taxed under the federal income tax laws) is not in excess of y3,a8f1'for the
�� SO D
immediately preceding calendar year.
1'hxt this affidavii is made for t.he purpose of having two thousand (32,000) dollars deducted from the assess-
ed ��aluation of the f lowin dex�`,bed tasab:e property for the year �19.O..y�, to wit: .........._ .........................
--
(� � ..................... x��w-i�- �- - - a6����!� .........i a.�,.. � ....:..................._.............-��-�-
//70- /o�f3o=//Loo
:;�ing the sspplicanYs principu] residenee pursuan to IC -11-12-11 and.6-11-12-12.
`�° � � .� � ����yy� .
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� A licnnt
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Subscribed and sworn to before me this ._.......__�.._.c............ day of .....<o L�� :............. 19.�i?.
fJIAR 3 1986 /
............................�...
� n �'�;-c"`7Y6+.-�' ..................�---.......
AUD�
FOR AUDITOft'S USE
Toial A,sessecl Value of Taxable Property for year 19..P.�?.._.,
- - - - - -- � .... . ...:........- � - -- - ..... Township, Real Estate
� n Corporation
A;sessed in the name of ...��-f'�'`.:...`,.�'...v.�ru,�.._....`��_....._..._.
(/ '
Amount of Taxable Property Deducted y5'.......___._ ...............: Net
F�ci�a .....mah<.�_.� .................. 19 g&-- -
�
0
/�/ 70 -�/o �3_0
f/o� �JdO-
$_ -- ....�._........
Value of Taxable Property $..._.....n . ..................
- �7�. .G_��-�.�..--� ... ....r._.
Auditor �