HomeMy WebLinkAboutAge_Townsend .4,4s rem APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
' 'a PROPERTY TAX BENEFITS _
\`,:'f /j. State Form 43708(R15/1-20) (/� P
,66. Prescribed by the Department of Local Government Finance /2:flIC 1 r / 20
161
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 Date: Form must,be completed and signed by December 31 and filed.with the county auditor or postmarked by the following
January 5 of the calendar year in which the property taxes are first due and payable.
See reverse side for additional instructions and qualifications.
Type of benefit requested(Please he k all that apply.)
Over 65 Deduction from Assessed Valuation Over 65 Circuit Breaker Credit
Name of applicant er ntr/ac`�( buyer)MIL n 7 id,
Is applicant the sole legal eq ' ble owner? If No,what is his/her exact share or interest? If owned with joint tenant or tenant in common,indicate with whom.
No
If name on record is diffe nt than that Of applicant,indicate below. Do all joint tenants or tenants in common reside on the property?
El 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?. ❑Yes ❑No
Address of contract seller.(number and street,city,state,'and ZIP code) I th roperty in question:
Real property ❑Mobile home(IC 6-1-1-7)
Taxing di r
exceed$200,000 for Over 65 Deduction or$199,999
❑Yes ❑No (counting just the homestead site]for the Over 65 Circuit Breaker Credit received before January 1,2020,and$199,999 fall Indiana real
property]for the Over 65 Circuit Breaker Credit initially applied for after December 31,2019.)See reverse for details.
Is the applicant 65 years of age or more on December 3 he year
es ❑No R la,64/___.
Have you filed for deductions in any oth co` ty? If Yes,what county?
❑Yes ,tlLplo
I/We certify under penalty of perjury that the above and foregoing information is true and correct. •
) AddrSignature o pplirant
eDate(month,day,year)
ss of applicant (number a tr et,city,state,an ZIP co e)
4 U LAAJLe_e_M-21___ OA( . -
Signal re of authorized representative Date(month,day,year)
'1'
Address of authorized representative (number and street,city,state,and ZIP code)
Signatur o...f.....C41.inty Auditor Date(month day,year)
.44...t../
•
,
SEP 17 2020
•
•
-:►y.,
GIBSON COUNTY A 4 DITI R
DISTRIBUTION: Original-County Auditor; File-Stamped Copy-Taxpayer