HomeMy WebLinkAboutAge_Williams (9) �yesr APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
PROPERTY TAX BENEFITS
State Form (R15/7-20) 3 �� 0 Zg ^2?
*` ✓ Prescribed by
the 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
indicate below. Do all joint tenants or tenants in common reside on the property?
(}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? lYes ❑No
Address of contract seller(number and street.city state,and ZIP code) Is the property in question.
®Real property ❑Mobile home(/C 6-1-1-7)
Taxing distract Key number/Legal description Record number Page number
Princeton 26-12-08-203-003.293-028
Does applicant reside on property? Assessed value of the property as of current year assessment date(May not exceed S200.000 for Over 65 Deduction or$199,999
®Yes ❑No (counting just the homestead site)forme Over ,65 Circuit Breaker Credit received before January 1,2020,and$199,999 fall Indiana real
property)for the Over
$
• individual's spouse.)See reverse for details.
Have you filed for any other deductions? If Yes,whet deductions?
WI Yes El No H/S & Mortgage
Have you filed for deductions in any other county? If Yes,what county?
❑Yes tNo
lANe certify under penalty of perjury that the above and foregoing information is true and correct.
n ure of appllca ?� �y Date(month.day year)
(�/S/�7.'�•/mot CC,+r.� , tt C�itali� 1 � � (YU4-- -6.41/42.Y
Addro of applica (number and street,city,state,and ZIP code)
1908 E Lake Road, Elrvaazuitl -lN 4767
Signature of authorized representative per;,,,a erotft) Date(month,day.year)
Address of authorized representative (number and street city,state,and ZIP code)
S e f ounty Auditor oonth day.year)
FILED
JUN 01 2022
DISTRIBUTION: Original-County Auditor: File-Stamped Copy-Taxpayer ,, � /
i7)2.e.c)_z/,'tom. L✓u. na)
GIBSON COUNTY AUDITOR