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HomeMy WebLinkAboutAge_Lofton ���"'••a APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR \�= PROPERTY TAX BENEFITS 14', dt'f State Form 43708(R15/1-20) G ��©� (/� •ai• troy /• 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 he k all that apply.) Over 65 Deduction from Assessed Valuation Over 65 Circuit Breaker Credit Name of a p (owner or con c e) I _ 1- 0 nv�� e_ � :?)-yCdtv-1 I}�i 1�iv ► S � �9 IS ilk '3 CA. 30 Do Is applicant the sole legal or equitable er? If No,what is his/her exact share or interest? If owned with)pint tenant or tena1/4at in common,indicate with whom. ❑Yes ❑No If name on record is different than that of applicant,indicate below. 1 Do all joint tenants or tenants in common reside on the prbperty? Li Yes ❑No Name of contract seller Has applicant owned or been buying the property under r corded contract for at least one(1)year before claiming deduction? es ❑No Address of contract seller(number and street,city,state,and ZIP code) Is t e operty in question: At, property ❑Mobile home(/C 6-1-1-7) Taxing district Key number/ egai description Record number Page number 0 (s . 26- 0 -2� —1 of -DO . 0-17 - 04, Does applicant reside on p .pe••? Assessed value of the property as of current year assessment date(May not exceed$200,000 for Over 65 Deduction or 5199,999 es ❑No [counting just the homestead site]for the Over 65 Circuit Breaker Credit received before January 1,2020,and$199,999 fall Indiana real property]for the _ the spouse's age at the time of death? •Adjusted Gross Income(AGI)of applicant,app is and spouse,or applicant $ S40,000(or individuals who tiled a joint return;or(3)S40,000 for individuals and all others that share ownership as joint tenants or tenants in common.For the Over 65 Circuit Breaker Credit,AGI may not exceed:(1)$30,000 for individuals who filed a single return;or(2)S40,000 for individuals who filed a joint return with the individual's spouse.)See reverse for details. TOTAL $ —I Have you filed for any other ded ctio ? l If Ye , abductions? es ❑No • {- r 0 1. Have you filed for deductions n a other c y? If Yes, hat county? �( TI 7`'1 ❑Yes a (� I/We certify under penalty of perjury tha the above and foregoing information is true and correct. Kignatu applicant Date(month d y,year • 2-OZC Address of applicant (numbber nd street,cif slate,and ZIP code) Signature of authorized representative Date(month,day,year) Address of authorized representative (number and street,city,state,and ZIP code) Signature of County Auditor O O' FILE, D Date(mg ,dear 7] 1 5 MAY 17 2023 AZIZILd a.i% > ) GIBSON COUNTY AUDITOR