HomeMy WebLinkAboutAge_Wolf io �� APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
! •, PROPERTY TAX BENEFITS
a�. State Form 43708(R13/4-15)
role~` Prescribed by the Department of Local Government Finance gb911 Qiq9
2) Mobile Homes assessed under IC 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 instrudtions and qualifications.
• Type of benefit requ sted lease check all that apply)
Over 65 Deduc.ffle,i ption from Assessed Valuation ❑ Over 65 Circuit Breaker Credit
Name of appplliicant(owner or contract buyer)
•
•
. .
Is applicant the sole legal or equitable r? If No,what is his/her exact share or interest? If owned with joint tenant or tenant in common,
indicate with whom
Yes ❑ No
If name on record is different than that of ED iapplicant,in�ica Do all joint tenants or tenants in ce mon reside on the property?
`` Yes ❑ No
Name of contract seller Has applicant owned or been buy g th property under recorded
JANI contract for at least one(1)year before claiming deduction?
JAN 0 2 2020 ❑ Yes ❑ No
Address of contract seller(number and street,city,state,and ZIP code) - Is the p pe in question:
Real property ❑ Mobile home(/C 6-1-1-7) '
MASON COUNTY
Taxi district Key number rcili Re rd number Page number��i/�� 2�-1So �10 • 0 . arnzz
7 � a�
Does'jiplicant 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(counting just the homestead site]for the Over
❑ No 65 Circuit Breaker Credit.)
YesSee
Have you filed for any other deductions? If Yes,what deductions? (Y�
Yes ❑ No \\\ -Ctl� rL + 1 Q-
Have you filed for deductions in any other coun If Yes,what county?
❑ Yes No
WM certify under penalty of perjury that the above an foregoing information is true and correct.
ignature of applicant Address of applicant (number and street city'state,and ZIP code) -
A/6Y 17. alglAt a.)
Sig lure of authorized representative Address of authorized representative (number and street,city,state,and ZIP code)