HomeMy WebLinkAboutAge_Waite <0 R` APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
• PROPERTY TAX BENEFITS
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& State Form 43708(R14/10-17) Gibson
Prescribed by the Department of Local Government Finance
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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 the following January 5.
2) Mobile Homes assessed under/C 6-1.1-7 or manufactured homes not assessed as real property:During the twelve(12)months
before March 31 of the year the deduction is to be effective.
Has applicant owned or been buying the property under recorded contract for
at least one(1)year before claiming deduction? ❑■Yes ❑No
Address of contract seller(number and street,city,state,and ZIP code) Is the property in question:
El Real property ❑Mobile home(IC 6-1-1-7)
Taxing district Key number/Legal description Record number Page number
Johnson Township 26-22-14-300-000.799-024
Does applicant reside on property? Assessed value of the property as of current year assessment date(May not exceed$182,430 for Over 65 Deduction or$159,999
■Yes ❑NO (counting just the homestead site)for the Over 65 Circuit Breaker Credit.)
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 ❑No Homestead
Have you filed for deductions in any other county? If Yes,what county?
['Yes ❑■ No
I/We certify under penalty of perjury that the above and foregoing information is true and correct.
Signature of applicant Date(month,day,year)
" 10/16/19
Address of applicant (number and street,city,state,and ZIP code)
12917 S Scottsdale Dr., Haubstadt, IN 47639
Signature of authorized representative Date(month,day,year)
Address of authorized representative (number and street,city,state,and ZIP code)
Signature of County Auditor Date(month,day,year)
.LA_ m 10/16/19
FILED
OCT 162019
DISTRIBUTION: Original-County Auditor; File-Stamped Copy-Taxpayer
GIBSON COUNTY AUDITOR