No preview available
Age_SpindlerAPPLICATION FOR SENIOR CITIZEN � � PROPERTY TAX BENEFITS � ` , Sqfe Form 43708 (R9 / 9-08) P�escnbad by the Departmeril ot Local Govemment Finance COUNTY � TOWNSHIP � YEAR j File Mark Infortnetan contained in th�s dowment �s CONFIDENTIAL pursuant to IC 6-1.1-12-9 and IC 6-1.1-35-9. ��-,d,, '�� INSTRUC710N5: tl To be fileC ln persan oi by mail with the Co�MyAutlita o7 the counry wAere the propeAy is localed. FAing Dates: 1) Reel Prt�perty: Durirg the hveNe (72) months belwe December 37 of fhe year the deduction is to �6e� +e7ffective,_� '(� p 2) Mobile Homes assessed unOer IC b f. f-7 or manWedured homes irof assessed as real piopeAy.tAUirg �e Fve0.MQf2) monNs be/ae Ma� 37 0/ the year the de0uc6on is to 6e eflecWe. See rererse side lar adddanel insLUCtions a� Qualificatlons. :/I7�,# � // • � rypeaea�ef+�eo�ertealp���xacrna�eaM� ,^;:;>ON COUNTY AUDITOR ❑ ❑ No I H neme on (amrtf b OEleram Man that d epp5mnt indicate bebw Name 01 mntratl axad must have Dean by'up m tmtract ef least orre (7) Yea� ' a� abeat ciry. sble. a� ZIP code) Key numbar / Leqal EescriDtion , a� -a3-�� i� s Uie D�M used end occupeE O�meM' br iisThat reskenw) Yes ❑ No Nas tha epd�M 65 yean ot age w mora on December 31 of tt+e year xior to the artenl yeaR Yes ❑ No AdJusted gross income of applicant, spouse, and any individuals aharing ownership (ForOver 65 deduction, income may not exceed 525,000; for fhe Over 65 Circuit Breaker Credit, income may rrot exceed 830, 000 /or individuals, or 540,000 for mamed couples). Mava you fibd far arry alhar deEutEms? Hava yau fileO tor deductions IIWe certify under pe of Indiana and owne sq���re a aad�cam � s " re°� � Y85 �'�O wumy? � Yes No �he tl owned with mmaone ather than spouse, indi�ate with wtrom pmperty � Mobile home QC 644-� mmber Pa9e numDar Assessed valua o( the pfoperty as of Mamh 1, wrran� year (may irot erceetl /or Orer 65 doducTian, ar 5166.000 lor Ne P.er 65 Cwicuit &oakw Crotliq � �� �y of perjury that the above and foregoing information is We and coirect and Ihat the applicant was a resident the aforementioned property on March 1, 20 / Address of apPlifant (num0er end stroeq city, sfafe, aM Z/P coEe) ��— / a 1�� S 5a W, -�� a,��oiqo�f ti1n �F��: rtve AdEress of euthorixed rap�esentativa (numboran s:�eef. ciry. staro, anE ZIP cotle)