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Home My WebLink AboutAge_Campbell �,E?n-; APPLICATION FOR SENIOR CITIZEN ol'7, .ca NTY TOWNSHIP YEAR � `t PROPERTY TAX BENEFITS " _.0,1 State Form 43708(R15/1-20) / Zo�� „� Prescribed by the Department of Local Government Finance Ji1 . 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 check a apply.) Over 65 Deduction from Assessed Valuation ❑Over 65 Circuit Breaker,Credit Name of a plicant(owner o�ntract buyer) 6_ __622_ . �QJ� ll 7ntract / n Is app nC the sole le al or equit o ner? If No,what is his/her exact share or interest? 6 If owned with joint tenant or tenant in common,indicate with whom. : es •❑No If name on record is different than that of applicant,indicate below. Do all joint tenants or tenants in common reside on the perry? • es ❑No Name of contract seller - • Has applicant owned or been,buying the property under recorded contract for at least one(1)year before claimi eduction? ['Yes III No Address of contract seller(number and street,city,state,and ZiP code) Is the operty in question: Real property ❑Mobile home(/C 6-1-1-7) Taxing district Key"numb r/Legal description Recocd'riumber Page number Does applica t reside on property? Assessed value of Me-propertyas of:current year assessment date(May not.exceed$200,000 for,Over 65 Deduction or$199,999 es El No (counting just.the homestead site]for the Over 65 Circuit Breaker Credit received before January 1,2020,and$199,999[all 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.yea age or more on December of the year $ individual's spouse.)See reverse for details. Have you filed for any other deduction If Yes,what ed ctio ? es '❑No -gP� /77A,-='•//� .Have you fled for deductions in ar:y other county?? ,what county? // ❑Yes f �" (/ I/We certify under penalty of perjury that the above and foregoing information is true and correct. . • Signet if:of applicant din, Date(month,d/ay,year A ress of applican num. �n street,citta ,and IP co 1 c2//7�-2,DP v , f ‘..gr, Signature of authoriz-:representative Date(month,day year) Address of authorized representative (number and street,city,state,and ZIP code) Signatur ofII�Co Auditor �1 � Date(month, 'ay,year) •is i ? (.., ..)...._ .F It.113, °. . DEC 17 2020 4em;_lja-t---- DISTRIBUTION: Original-CountyAuditor; File-Stamped GIBSON CO UNTY A,u,,,0 OR gCopy-Taxpayer Actr.4, APPLICATION FOR SENIOR CITIZEN LINTY' TOWNSHIP YEAR PROPERTY TAX BENEFITS I,\ .r I' State Form 43708(R15/1-20) 4.(FA 1 II!y ? Prescribed by the Department of Local Government Finance ,Litt �� vvv vvv��, 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 check at apply.) Over 65 Deductionion from Assessed Valuation ❑Over 65 Circuit Breaker Credit • NAtf an^anl(gwner or contract,6buyer) ,��/10 yr` 4�iV lei/ Fq loGll53 59 `/G// Giui Is applicant the sole lega�uitable.owner. If No,what is his r exact share o interest. If owned with joint tenant or tenant in common,indicate with whom. Lpyes .-❑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? ill Yes III 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 ntract seller(number and street,city,state,and ZIP code) Is the pr rty in question: Real property ❑Mobile home(IC 6-1-1-7) Taxi ist ct ex ., 'Ke mber/Legal description., Record number Page number Doe applicant reside on property? Assessed value of the--property as of current year assessment date(May not exceed$200,000.for Over 65 Deduction or$199,999 es ❑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 Over 65.Circuit Breaker Credit initiallyappIied for after December 31;2019.)See reversefor detail.., Is the applicant 65.ye s of age or more on December 31 the year $ • individual's spouse.)See reverse for details. Have you filed for any other deductions If Yes,what deductions'? — I es ❑No �,,�pf1//' Have you filed for deductions in any other cou - If Yes,what county?' • ❑Yes: No. INVe certify under penalty of perjury that the above and foregoing information is true and correct. . Signature of applicant Date(month,day,ye r) is li7 aoa6 Address of a licant (num r a d street,ci ,state,an ZIPç de) /g I ® /Vf_ git t!to L NZ 1- (U7 Signature of authorized representative Date(month,day year) Address of authorized representative (number and street,city,state,and ZIP code) Signatu f untyAugitor Date(mont ,day,yea) '(C5.---' . 1 o? 1 7 ,-fDAD . 'FILTPD DEC 17 2020 DISTRIBUTION: Original-County Auditor; File-Stamped Copy-Taxpayer GIBSON COUNTY AUDIT R