Age_McKinney °' o APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP I YEAR '
PROPERTY TAX BENEFITS IL ' �®�""!�B
•S - —! Slate Fonn 43708(R9/9-08)
l'us Prescribed by the Department of Local Government Finance �r frlt°7'�{,',t'
Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-12-9 and IC 6-1.1-35-9. APR 1 6 fd 1° ark
INSTRUCTIONS: likemolter
To be filed in person or by mail with the County Auditor of the county where the property is located.
Filing Dates: 1) Real Property:During the twelve(12)months before December31 of the year the detitggi3k te9WFW AUDITOR
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.
Type of banal requested(please check all that apply)
kJ Over 65 Deduction from Assessed Valuation Over 65 Circuit Breaker Credit
Name of applicant(owner or contract buyer)
Is applicant the sole legal or equitable owner? If No,what is his/her exact re 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 Opponent must have been buying co contract at least one(1)year)
Address of contrail seller(number and sheet,city,state,and ZIP code) Is the property in question:
❑ Real property ❑ Mobile home(IC 6-1-1-7)
Taff district Key number/Legal description Record number Page number
Is the property used and occupied primarily for
`°
❑ Yes ❑ No
I/We 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 of applicant Address of applicant (number and street,city,state,and ZIP code)
1
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Signature of a orrz p nta • / \ Address of authorized prase alive (number and sweet,city,state,and VP code)