HomeMy WebLinkAboutAge_Barrett (2) tc APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
PROPERTY TAX BENEFITS
a';"','', i. State Form 43708(R14/10-17)
.''e " Prescribed by the Department of Local Government Finance Gibson
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.
See reverse side for additional instructions and qualifications.
Type of benefit requested(Please check all that apply)
0 Over 65 Deduction from Assessed Valuation ❑■ Over 65 Circuit Breaker Credit
Name of applicant(owner or contract buyer)
Patricia& Doyin Barrett
Is applicant the sole legal or equitable owner? If No,what is his/her exact share or interest? If owned with joint tenant or tenant in common,indicate with whom.
❑■Yes ill 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?
lil Yes ❑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? OYes [[No
Address of contract seller(number and street,city,state,and ZIP code) Is the property in question:
0 Real property ❑Mobile home(IC 6-1-1-7)
Taxing district Key number/Legal description Record number Page number
Princeton 26-12-18-101-000.096-028
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
0 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.
ignature of applicant if Date(month,day,year)
inf 11/8/19
Address of applicant er tr et,city,state,and ZIP code)
715 S Hall St., Princeton, IN 47670
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)
U.-2 11.40 11/8/19
FILES>
NOV 0 8 2019
DISTRIBUTION: Original-County Auditor; File-Stamped Copy-Taxpayeriitemoga------
GIBSON COUNTY AUDITOR