Age_Taylor d�ytt=.r. APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
PROPERTY TAX BENEFITS
State Form 43708(R15/1-20) Gibson Owensville 2022
''+ ✓' 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 I Over 65 Circuit Breaker Credit
Name of applicant(owner or contract buyer)
Cheryl Taylor
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?
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? IZ Yes ❑No
Address of contract seller(number and street,city,state,and ZIP code) Is the property in question:
I]Real property ❑Mobile home(IC 6-1-1-7)
Taxing district Key number/Legal description Record number Page number
Owensville 26-17-12-202-000.147-022
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
(counting just the homestead site]for the Over 65 Circuit Breaker Credit received before January 1,2020,and$199,999(all Indiana real
IZ�Yes ❑NO property)for the Over 65 Circuit Breaker Credit initially applied/or after December 31,2019.)See reverse for details.
Is the applicant 65 years of age or more on December 31 of the year
$
individuals spouse.)See reverse for details.
Have you filed for any other deductions? If Yes,what deductions?
IZIYes ❑No Homestead, Mortgage
Have you filed for deductions in any other county? If Yes,what county?
DYes [ONo
I/we certify under penalty of perjury that the above and foregoing information is true and correct.
Date(month,day,year)
Signature of applicant 10/12/2022
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Address of ppli nt (number and street,city,state,and ZIP code)
106 E Warrick St., Owensville, IN 47665
Date(month,day,year)
Signature of authorized representative
Address of authorized representative (number and street,city,state,and ZIP code)
Date(month,day,year)
Signature of County Auditor _^ - Q W 4 4qL_.:,f rr 1") 10/12/2022
FILED
OCT 1 2 2022 '
Taxer
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Taxpayer Yhee,z —e `�'" �-z4;n
DISTRIBUTION: Original-County Auditor; File-Stamped Copy- p y GIBSON COUNTY AUDITOR