HomeMy WebLinkAboutAge_Wyatt •=Tit• APPLICATION FOR SENIOR CITIZEN
�i;•. � tCOUNTY TOWNSHIP YEAR
_„41 PROPERTY TAX BENEFITS 1 2
�\ "jam state Form by the (R15/1-20) C ^ ��j
,\ = J ' \ ?
'' Prescribed 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
❑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 re or d contract for
at least one(1)year before claiming deduction?
Yes ❑No
Address of contract seller(number and street,city,state,and ZIP code) Is��broperty in question:
LQ�Real property ❑Mobile home(/C 6-1-1-7)
Taxing district Key number/Legal description
26-\Z—O7—Vol—f3C . 131 —02 2' Record number Page number
I()
Does applicant reside on pr rty? Assessed value of the property as of current year assessment date(May not exceed$200,000 for Over 65 Deduction or$199,999
Yes ❑No (counting just the
l/_of1 LAYes No ]`_Yes what co
unty?
r
Have you filed for d-.uctio .i an other ty? If Yes, county?
❑Yes o
I/We certify under penalty of perjury that the above and foregoing information is true and correct.
....Ci lure of applica Date(month,d/ r)
Address of applicant (number and street,city,state,and ZIP code)
a
re of authorized representative ^
Signature of County Auditor Date(month,day,year)
FILED
DEC 3 0 2022
2ZC.A. .,_e a. .1�. .6,t4->
GIBSON COUNTY AUDITOR
DISTRIBUTION: Original-County Auditor; File-Stamped Copy-Taxpayer