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.NE 7•*e APPLICATION FOR SENIOR CITIZEN Q Sc�SSe� COUNTY TOWNSHIP YEAR
m; PROPERTY TAX BENEFITS
" j`,..,E : State Form 43708(R15/1-20)
- 131.1,-.)- o ( Gibson Princeton 2020
iee'�J* Prescribed by the Department of Local Government Finance MQ U
.0 -( �, 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 all that apply.)
®Over 65 Deduction from Assessed Valuation ®Over 65 Circuit Breaker Credit
Name of applicant(owner or contract buyer)
Larry Chandler
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?
Yes El 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? 11 Yes ❑No
Address of contract seller(number and street,city,state,and ZIP code) Is the property in question:
®Real property ❑Mobile home(IC 6-1-1-7)
Taxing district Key number/Legal description Record number Page number
Princeton 26-11-01-404-000.665-028
Does 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
®Yes ❑No [counting just the homestead site]for the Over 65 Circuit Breaker Credit received before January 1,2020,and$199,999 tall Indiana real
property]for the Over 65
$
individual's spouse.)See reverse for details.
Have you filed for any other deductions? If Yes,what deductions?
7IYes ❑No Homestead
Have you filed for deductions in any other county? If Yes,what county?
III Yes I2:1No
I/We certify under penalty of perjury that the above and foregoing information is true and correct.
)segnature f`applicant /7 Date(month,day,year)
/1/��t� e " o.-1_ 12/28/2020
Addres of applicant er and street,city,state,and,ZIP code)
586 W Glend4 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)
�--r_kx.., • .-4,./,-,-)V 12/28/2020
FILED
DEC 2 8 2020
DISTRIBUTION: Original-County Auditor; File-Stamped Copy-Taxpayer r--
GIBSON COUNTY AUDITOR