HomeMy WebLinkAboutAge_Brown N/6" fy, APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
.1. PROPERTY TAX BENEFITS
J ,:_` \l i State Form 43708(R15/1-20)
is% Prescribed by the Department of Local Government Finance
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)
Linda/ Brown
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 ❑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?
l]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?
IZYes ❑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
year assessment date(May not exceed$200,000 for Over 65 Deduction or$199,999
[counting just the homestead site]for the Over 65 Circuit Breaker Credit received before January 1,2020,and$199,999[all Indiana real
®Yes ❑No
property]for the Over 65 Circuit Breaker Credit initially applied for after December31,2019.)See reverse for details.
Is the applicant 65 years of age or more on December 31 of the year �,^
$
individual's spouse.)See reverse for details.
Have you filed for any other deductions? If Yes,what deductions?
®Yes ❑No H'stead/Mortgage/Disability
Have you filed for deductions in any other county? If Yes,what county?
['Yes l21No
I/We certify under penalty of perjury that the above and foregoing information is true and correct.
i ature of a lican o Date(month,day,year)
Xis , t3 1 Lo� A., k ► a-a�- cQoaz)
Address of applicant (number and street,city,state,and ZIP code)
1307 E Taftown RD, P'ton, IN 47670
Signature of authorized representative Date(month,day,year)
Address of authorized representative (number and street,city,state,and ZIP code)
Sig ature of County Auditor Date(month,day,year)
1,Thrszsx...3
FILE 11
DEC 2 8 2020
DISTRIBUTION: Original-County Auditor; File-Stamped Copy-Taxpayer 412nt:cl------
6
GIBSON COUNTY AUDITOR