Age_Mcgarrah .r,1;�"w APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP I YEAR '
PROPERTY TAX BENEFITS -
- State PROPERTY
Form 43708(R9/9-08)
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mi. ' Prescribed by the Department of Local Government Finance
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Information contained in this document is CONFIDENTIAL pursuant to IC 611-12-9 and IC 6-1.1-359. 1
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INSTRUCTIONS:
To be filed in person or by mail with the County Auditor of the county where the property is located. APR 25 2014
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 property: the twe a(72Jlaonths
before March 31 of the year the deduction is to be effective. !�
See reverse side for additional ins lions and qualifications. GIBSON COUNTY AUDITOR
Type of beneft requested(#ea eck all that apply)
Over 65 Deduction from Assessed Valuation Over 65 Circuit Breaker Credit
Name ofapp&ra = or mn`vactbuyer) //y/'�/�
Is applicant the sole or equitabi id her? If No, �s/her exact share or interest? If owned with someone other than spouse,
RC� indicate with whom
R ❑ 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(7)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)
Taxing district Key number I Legal description Record number Page number
a6—ir Woa-001.962 D S
Is the property used and occupied primarily for Assessed value of the property as of March 1,current year(may not exceed 5782,430
his/her residence? tor Over 65 deduction,or 5160,000 for the Over 65 Circuit Breaker Credit)
Yes ❑ No
Was the applicant 65 years of age or more on December 31 e year
Have you fled for any other deductions? If Yes,what deductions?
❑ Yes I INo
Have you filed for deductions in any other county? If'Ites,what county?
❑ Yes Ill No
UWe 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 a r nt Address of applicant (number beet,city,state,and ZIP code)
rn cj/ I a a l t k S pteAl a 7)
Sign ure of authorized rep emative Address of authorized representative (number and street,city,state,and ZIP code)
