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HomeMy WebLinkAboutAge_Cutright �'%". APPLICATION FOR SENIOR CITIZEN co TOWNSHIP� • - F,= PROPERTY TAX BENEFITS State Form (t,9/9-08) �.�. Prescribed by the Department of Local Government Finance - M•©? Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-12-9 and IC 6-1.1-35-9. 1 INS7RUCT1ONS: SEP 2 3 2013 To be filed in person or by mail with the CountyAuditor of the county where the property is located. Filing Dates: 1) 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 pmperryl�nnC tt 7T2 months before March 31 of the year the deduction is to be effective. G I BSO N COUNTY AUDITOR See reverse side for additional instructions and qualifications. Type of beneft requested(please deck all that apply) el Over 65 Deduction from Assessed Valuation [Dver 65 Circuit Breaker Credit Name of applicant(owner or contract buyer) Is applicant the lega�equitable owner? If No,what is his/her ct 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 contract seller(number and sheet,city,state,and ZIP code) Is the property in question: mR eat property ❑ Mobile home(IC 6-1-1-7) tinict Key number I Legal description Record number Page number • iZQ/I/ J a/—J, -/k -&63 0o3/8' 3 odd Is the property used and occupied primarily for Assessed value of the property as of March 1,current year(may not exceed$182,430 his/her residence? for Over 65 deduction,or 516600 000 tor the Over 65 Circuit Breaker Credit) ❑ Yes ❑ No Was the applicant 65 years of age or more on December 31 of the year Have you filed for any other deductions? It Yes,what deductions? Yea nNo /{S (29 Have you filed for deductions in any other county? If hiss,what county? Yes No l I/uVe 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 Signature of applicant Address of applicant (number and street,city,state,and ZIP code) X L--- )22.-z- Sf 567/71 Signature of authorized representative Address of autlxni : representative (nranber and street,city,slate,and ZIP code) it