HomeMy WebLinkAboutAge_Spurgeona�,�";"o APPLICATION FOR SENIOR CITIZEN couNTr TOWNSHIP vena
<E-__. ' PROPERTY TAX BENEFITS �
3� i. +' Stare Fortn 43708 (R10 / 12-08) �
•��—�° Prescn�ed by the Department of Local Govemment Finance �
Infortnation contained in this documeni is CONFIDENTIAL pursuant to IC 6-1.1-12-9 and IC 6-1.135-9.
DEC 2 9 2p1�''e
INSTRUCTIONS:
To be filed in person or by mail with the CountyAuditoro/the county where the propertyis located. GIBS(�N ���1NT�'�
Filing Dafes: i) Real Property: Dunng the M1velve (12) months befo2 December 31 of the year the deduc ion �s o e e � DITI R
2) Mobile Homes assessed under IC 6-1.7-7 or manu/acfured homes not assessed as real property: Dunng the tweNi (72) months
be7o2 Maroh 37 0l the year the deduction is to be eNective.
See 2verse side Ior additional instructions and qualifications.
Type of benefit requested (p/ease check all fhat apply)
�Over 65 Deduction from Assessed Valuation
Name of applicant (owne� or contracf buye�J
Q � V
Is app cant Ue sol egal or equitable owner? If No at is his/her exact share or
❑ Yes ❑ No
If name on record is diRerent ihan that of applicant, indica;e below
Name of mn',ract seller (applican( must have been buying on crntract at leasi one (7) year)
�ver 65 Circuit Breaker Credit
If owned with someone oNer
indicate vnth whom
Adtlress of mnvact seller (number and sf2ef, uty, state, and ZIP code) Is ;he property in question:
� Realproperty ❑ b
Taxmg stnct � Key number / Legal desuiption Record number
�/��'�-c�� a � - // - o! - Y� 3 - oo.t . � � ' - o � 8
Is Ne property used and oaupietl primanly tor �lssessed value of the pmperty as of March 1, arrent year
his/her residence? forOver 65 deduction, or 5760,000 /orthe Over 65 Circuit I
[�i Yes ❑ No
Was Ne applicant 65 years of age or more on December 37 ot ihe year
prior to ihe year taxes are frst due and payable?
❑ Yes ❑ No
Adjusted gross income of applicant, spouse, and any
individuals sharing ownership (ForOver 65 deduction, income
may nol exceed 525,000; /or the Over 65 Cirouit Breaker Credit,
income may not exceed 530,000 !or individuals, or S40,000 lor
manied couples).
Have you file0 tor any other deductions?
� Yes ❑ No
Have you filed for deductions in any other county?
❑ Yes ❑ No
was a resident
. �it�
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