Age_Armstrong 1,,spf, APPLICATION F SENIOR CITIZEN COUNTY TOWNSHIP YEAR
l' qi PROPERTY TA BENEFITS
d' =:i '. l3 I=
,.r j• StatesForm 708the eat - /�1 cO " Q
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.®'" Prescribed by the Department of Local Government Finance `,J , 1g
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
0 er 6 seduction from As - ed Valuation ver 65 Circuit Breaker Credit
i 1 J"' Y
Name of applicant(owner or contract buy.r)) ,�^��� M� 1 ��t .
Is applicant the sole legal or eq able o -- 9 If . : O. - - exact share or interest?_ v 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 t roperty?
Yes ❑No
Name of contract seller Lln COIII ` Has applicant owned or been buying the property under recorde ntract for
at least one(1)year before claiming deduction? es ❑No
Address of contract seller(number and street,city,state,and ZIP code) Is the erty in question:
22Z 6 C Gum Sc ^ E 1v'fl e^ ,51) r-L fl 1 Real property ❑Mobile home(IC 6-1-1-7)
Taxing district Key number!Legal descriptjon Record number Page number
Ogg 2-6-11-12--2t06-'O 0 S . 6 \2 —'0 28 .
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
El Yes ❑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
$
individual's spouse.)See reverse for details.
Have you filed for any other deductio . If Yes,what de ctions'� (1 \\ ,,,,//�� ��-�,
es ❑No I-1 s 6 `'H _ —D 1 S mj1 11' CI)•0) Seij� •
Have you filed for deductions in any other cou If Yes,what county?) J1 ) ��J
❑Yes No
INVe certify under penalty of perjury that the above and foregoing information is true and correct.
X Signature of applicant Date(morgth,daleyear)
�� C ilia 12121202 -
A�dress of app'1 pt (n .-r and street,cijy itgte,and ZIP code �� ,
`�L �6 lv : LI s� ItOn - 9,�- 6 11
Signature of authorized representative' Date(mont ,day,y ar)
2�1 �1 209/40
dress f authorized represents' (number and street,city,state,and ZIP code)
Signs Coat-
----) Date(month, r)
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NO DO
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DISTRIBUTION: Original-County Auditor; File-Stamped Copy-Taxpayer G�� O