HomeMy WebLinkAboutDisabilty_Turner - ''_ ., APPLICATION FOR BLIND OR DISABLED PERSON'S coutm TOWNSHIP YEAR
rr � DEDUCTION FROM ASSESSED VALUATION
State Form 43710(R9/9-08)
44 Prescribed by the Department of Local Goverment Finance
Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-12-12(b). ��- File Mark
INSTRUCTIONS: IL ED
,
IN be filed in person or by mall with the CountyArrdrtor of the county where the property is located. 9�-'+J-
F1lirg 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 Properly NOV During g 6 Jyahre(12)months before
March 31 of each year the individual wishes to obtain the deduction. L Pt
See reverse side for additional instructions and qualifications.
Name of applicant(owner s buyer) �T�(,'!�'�'
S C"^1,11 AIBSON BOUNTY AUDITOR
Is applicant the sole legal or equitable owner? If No,what is hLNher exact share of interest? gowned with someone odner than spouse.
adicate w9h whom:
D Yes ❑No
If name on rend Is different than that of applicant,indicate below.
•
Name of contact seller
Address of contraa seller(number and street cat:sate,and ZIP code) Is the property in question
❑ Real Property ❑ AnnuallyAssessed
Mobile Home(IC 6-11-7)
Is applicant blind as defined In IC 12-7-2-21(1)? Is want disabled and unable to engage In any substantial activity
as defined in IC 6-1.1-12-11(d)?
❑Yes ❑No es ❑No
Is the property used end occupied primarily for hisfar residence? exceed$1 ?Does the applpwf 0sanfs taxable gross income for the preceding calendar year
❑Yes 0 N El Yes El No
Taxing district Key number I Legal desolation Record number Page number
a (-la-. -loa- to . ' 9s-cal
Ilwe 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
Signahrte of Address of applicant (number and sheet city,stale,and ZIP code)
t.4- ,, i S rY \Qom. k i, �! ?6 7l�
sigraaae of Address of authorized representative (number and street cat,state,and ZIP code)