HomeMy WebLinkAboutAge_Mason (5) ,.% APPLICATION FOR SENIOR CITIZEN COUNTY I TOWNSHIP I YEAR
PROPERTY TAX BENEFITS
State Forth 43708(R9(9-08)
' .i.% Prescribed by the Department of Loral Government Finance
File Mark
Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-12-9 and IC 6-1.1-35-9. FILET)
INSTRUCTIONS: F I ® E
To be filed in person or by mail with the County Auditor of the county where the property is located. ���tttJJJ���ILL�..I/J A
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:,c�¢nry pie 484412)months
before Mardi 31 of the year the deduction is to be effective.
See reverse side for additional instructions and qualifications.
Type of beneft requested(please checkaD that apply) GIBSON COUNT�D AUDITOR
Over 65 Deduction from Assessed Valuation TSI,Over 65 Circuit Breaker Credit
Name of applicant(owner or contract buyer) /1� 040�_
Is applicant the sole leg eas
qu i R If No,what is his/he` a act share or interest? If owned with someone other than spouse.
indicate with whom
la Yes ❑ No
If name on record is differertban that of applicant indicate below
Name of cantr/p ct seller(applicant must have been owing on contract at least ono(1)yea,
Address bon tract seller(number and street,city,state,and ZIP code) Is the property in question:
I Weal property ❑ Mobile home(IC 6-1-1-7)
Taxing district �, Key number/Legal description Recant number Page number
/1. ukef 1a-- (,_ ia_107-yoa-006477-oar?
Is the property used and occupied primariy for Assessed value of the property as of March 1,current year(may not exceed 5182,430
his/her residence? for Over 65 deduction,or 5160,000 for the Over 65 Circuit Breaker Credit)
❑ Yes ❑ No
was the app cant 65 years of age or more on December 31 of the year
I I Yes ❑ No
1/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 .
Signature of applicant Address of applicant (number and street,city,state,and ZIP code)
Signature of authorized representative Address of authorized representative (number and street,city,state,and ZIP code)