Age_Bobbitt APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
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11 PROPERTY TAX BENEFITS
, State Form 43708(R15/1-20) pai-ov.". 03
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-,---------1T Prescribed by the Department of Local Government Finance
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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.
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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(owner or contract buyer)
Is applicant the sole legal or equitable owner?1 If No,what is his/her exact share or interest? If owned with joint Jnant or tenant in common,indicate with whom.
11?‹; ENO
1 If name on record is different than that of applicant,indicate below. I Do all joint tenants or tenants in common reside on the prIpperty?
EZ„Yerr 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?
111No
Address of contract seller(number and street,city, state,and ZIP code) Is the property in question:
D-R651 property Ei Mobile home(IC 6-1-1-7)
Taxing district Key number/Legal description Record number Page number
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Does applicant reside on properly?"' 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
$
individual's spouse.)See reverse for details.
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Have you filed for any other deductions? If Yes,what deductions?
Have you filed for deductions in any other county? If Yes,what county?
El Yes 44.1.5— eyx,t--- oy-, Pr,E, 239.2 ji
I/We certify under penalty of perjury that the above and foregoing information is true and correct. k.....,
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Address of aUnt (number and street,city,state,and ZIP code)
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Signature of authorized represen ative Date(month,RAyely 5 2023
Address of authorized representative (number and street,city,state,and ZIP code)
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Datf AUDITOR
Signature of County Auditor id ALL righ5Rivij3;,y0TY
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