HomeMy WebLinkAboutAge_Belcher (2) GyAPPLICATION FOR SENIOR CITIZEN FDJT� DI YEAR
PROPERTBENEFITS State Form 43708(R9/9-08)
Prescribed by the Department of Local Government Finance
APR 16 ubJark
Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-12-9 and IC 6-1.1-35-9.
INSTRUCTIONS:
To be Ned in person or by mail with the CountyAuddor of the county where the property is located. GIBSON COUNTY AUDITOR
Filing Dates: I) Real Property:During the twelve(12)months before December 31 of the year the deduction is to be effective.
2) Mobile Homes assessed under IC 6-1.1-7 or manufactured homes not assessed as real property:During the twelve(12)months
before March 31 of the year the deduction is to be effective.
See reverse side for additional instructions and qualifications.
N
Type of banal requested check as that apply)
Over 65 Deduction from Assessed Valuation Over 65 Circuit Breaker Credit
Name of applicant(owner or contract buyer)
Is applicant the sole legal or equit ble owner? If No,what is his/her exact share or interest? If owned with someone other than spouse.
indicate with whom
Yes ❑ No
If name on record is different than that of applicant indicate below
Name of contract seller(applicant must have been buying on contract at least one(1)year)
Address of contrail seller(number and street city,state,and ZIP code) Is the property in question:
E Real property ❑ Mobile home(IC 6-1-1-7)
Taxing strict � Key number/Legal description Record number Page number
A.A.vt-c.ei ab-li gA - zoy- 000.0 v3_ oa8
Is the property used and occupied primari'for
❑ Yes ❑ No
INJe certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant was a resident
of Indiana and owner of the aforementioned property on March 1,20
Sign re of appfiicaM Address of applicant (number and street,city,state,and ZIP code)
Y4oz ti. EM6.r $1. 0'frfncf, ,,, IW9Zi7o
S. at re of euthorrz representative Address of authorized representative (number and street,city,state,and ZIP{ode)