HomeMy WebLinkAboutAge_Crawford 2.
n"., APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR '
r'�..'-''�?; PROPERTY TAX BENEFITS
S -I State Form 43708(R9/408)
•o. Prescribed by the Department of Local Government Finance
( -
Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-12-9 and IC 6-1.1-35-9. -
INSTRUCTIONS: JUL 12014
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 deducti.a: o bee - =
2) Mobile Homes assessed under IC 6-1.1-7 or manufactured homes not assessed eat...../..
..../..-h- ni•q].•;13,-1 :^? 2)months
before March 31 of the year the deduction is to be effective. COUN
See reverse side for additional instructions and qualifications. TM
AUDI TQR
Type of benefit requested(plea check at that apply)
Re
Over 65 Deduction from Assessed Valuation 8er 65 Circuit Breaker Credit
Name of�y�n�r,pca/ntt-(onllnerorcontract buy/1err)'.{'/��.1�G����.
Is applicant the sole legal or equitable rnmeR o.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 of least one(1)year)
Address of contract seller(number and street,city,state,and ZIP code) Is the property in question:
❑ Real property ❑ Mobile home(IC 6-1-1-7)
Taxing district Key number/Legal description Record number Page number
247- 11—l2-a011-0o0 2143-sad?•
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$160,000 for 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? If Yes.what deductions?
111 Yes 0 N
Have you filed for deductions in any other county? If Yes,what county?
❑ Yes ❑ No
I a e certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant was a resident
•Indiana and owner of the aforementioned property on March 1,20
• afore of tip• •- Address of app8cam (number and street,city,state,and ZIP code)
•
i gnat>if ure of- • ed reef entattv, Address of authorized representative (number and street.city,state,and ZIP code)