HomeMy WebLinkAboutAge_Roberts "o APPLICATION FOR SENIOR CITIZEN COUNTY I TOWNSHIP YEAR
a PROPERTY TAX BENEFITS
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/ State Form 43708(R13/4-15)
•.<u' Prescribed by the Department of Local Government Finance
File Mark
Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-35-9.
INSTRUCTIONS:To be filed in person or by mail with the County Auditor of the county where the property is located.
Filing Dates: 1) Real Property:Form must be completed and signed by December 31 and filed or postmarked by of g Ja
2) Mobile Homes assessed under IC 6-1.1-7 or manufactured homes not assessed as real propert . unrfg++.. hs
before March 31 of the year the deduction is to be effective.
See reverse side for additional instructions and qualifications. APR 2 3 2018
Type of benefit requested(please check all that apply)
M Over 65 Deduction from Assessed Valuation I XOver 65 Circuit Br Ir��[�`
i7HSTJ OUNTY AUDITOR
Name of applicant(owner or contract buyer)
__ �
interest? If owned with joint tenant or tenant in common,
indicate with whom
1p Yes ❑ No
If name on record is different than that of applicant,indicate below Do all joint tenants or tenants in common reside on the property?
E7Yes U No
Name of contract seller Has applicant owned or been buying the property under recorded
contract for at least one(1)year before claiming deduction?
❑ Yes ,g No
Address of contract seller(number and street,city state,and ZIP code) Is the property in question:
lir Real property ❑ Mobile home(IC 6-1-1-7)
Taxing district ,,,,"� Key number/Legal description Record number Page number
V + � Zia-fin-we 00/.50 5. ozi
Does applicant reside on property? Assessed value of the property as of current year assessment date(may not exceed
5182,430 for Over 65 Deduction or 5159,999(counting just the homestead site)for the Over
ID 65 Circuit Breaker Credit.)
p Yes See reverse for details.
Is 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?
Yes U No /f 3
Have you filed for deductions in any other county? If Yes,what county?
❑ Yes No
IMfe certify under penalty of perjury that the above and foregoing information is true and correct.
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)
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