HomeMy WebLinkAboutAge_Harper •,47..,,?,,, APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
A PROPERTY TAX BENEFITS .
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-..i.. ,_7/ State Form 43708(R15/1-20) / L
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Prescribed by the Department of Local Government Finance )C\AC..eon
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.
Name of applicant(owne, contract,buyer) ,
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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.
P'fes E]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?
0 Yes 0 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?
ilttcg- 0 No
Address of contract seller(number and street,city,state,and ZIP code) Is the property in question:
Erli;a1 property 0 Mobile home(/C 6-1-1-7)
Taxing district ,-, .. Key number/Legal description Record number Page number
C.2/b• ;)r) 06 -0-oe_ 0 3-oco, /-21-oa F .
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
[: }Yl-s- 0 No [pcomuntingit rstylpee(,:1,7v0:7,
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Address ar=ant (number and stre city,state,and P code)
30/ j--/a rdi v.c Ave., 'P C\ e-f,c>r‘ 1-1-:iu Le'7O. 70
Signature of authorized repressintative Date(month,day,year)
Address of authorized representative (number and street,city,state,and ZIP code)
Signature of Cou uditor 1 j Atei... .„ Date(month,day,year)
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FILED
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DEC 2 7 2021
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GIBSON COUNTY AUDITOR
DISTRIBUTION: Original-County Auditor; File-Stamped Copy-Taxpayer