HomeMy WebLinkAboutDisabilty_Figgins +°• APPLICATION FOR BLIND OR DISABLED PERSON'S COUNTY il rowNSNIP YEAR
, ?' DEDUCTION FROM ASSESSED VALUATION L` iT
Stabs Form A37lO(R91 s-08) '
t Presorted by the Department of Local Government Finance
Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-12-12(b). AUG 24
INSTRUCTIONS:
To be filed in person or by mail with the County Atrdrtor of the county where the property is located.
Filing Dates: 1) Real Property:During the year for which the deduction is sought.
2) Mobile Homes assessed under IC 6-1.1-7 or Manufactured Homes not assessed as Real ProicayStithingthblfWWWWINIPen2f before
March 31 of each year the individual wishes to obtain the deduction.
See reverse skis for additional instructions and qualifications.
Name of /(ownerar contact buyer`)//Q
Ls applicant the sole legal or equitable(dlw'(e/r •what is his/her exact share of interest? If owned with someone other than spouse,
indicate with whom:
El Yea 0 N
If name on record Is different than that of eppefant indicate below
Name of contract seller
Address 5,.rernan. seller(Mber and street,city,state,and7 ZIP code) :L/8 roperty in question:0:!? aliz� V �� k ar RealP ❑ Annually Asses lid
Aoh7e Fame C 6
1.1-
n
Is applicant blind as defined in IC 12-7-2.21(1)? Is applicant drsab ed and unable to engage in any substantial gainfid aC'mty
`11 as defined In IC 6-1.1-12-11(d)?
❑Yes No fYes ❑No
prima*the property used end occupied prima for residence? Does the aaoFca preceding nfe taxable grass income for the preding calendar year
exceed their An-
-No
❑ ,,��
No ❑Yes �n-No
Tadng> pct Key minter I Legal description Record number Page number
Qs
/.!y//✓// i ar 4-A4-o 2aoi 6 °1. 929-aa2
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 .
Sgr�ot-J��pg rt— Address of applicant (number and street,cdy,state.and ZIP code)
/�) /%/)" ////`/` A. y/at 2, A-!N ✓r sr ejir96iTa ) „co 1?4
Signature of authorized Address of authorized representative (number and street,city state,and ZIP code)