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HomeMy WebLinkAboutAge_Lloyd ���"=� APPLICATION FOR SENIOR CITIZEN . ,`�,�� COUNTY TOWNSHIP YEAR Iir . PROPERTY TAX BENEFITS '�J -1 State Form 43708(R16/1-23) �; Pr't h .`"1, 3�• Prescribed by the Department of Local Government Finance �� 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 Below Do All 4zi9Nenants or Tenaftlein Common Pr operty? on the Pr perty? CienR ❑ No Name of Contract Seller Has Applicant Owned or Bought the Property Under Recorded Contract for at Least Pr One(1)Year before Claiming Deduction? t!YYes ❑ No Address of Contract Seller(number and street,city,state,and ZIP code) Is the Property/�' in Question: L(d'Rea 1`S c P l Property ❑ Mobile Home(IC 6-1.1-7) Taxing District Key Number/Legal Description Record Number Page Number P 1 • lfl.- Ia-O%_ 3n( -- ©oI. -0 . Does Applicant Resid on Property? Assessed value of the property as of current year assessment date(May not exceed$240,000 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[al Yes ❑ No Indiana real property]for $ Have You Filed for Any Other Deductions? If Yes,What Deductions? a Yes ❑No - &0-4-YNe.- e--QO1 Have You Filed for Deduction in Any Other County? If Yes,What County? ❑Yes Eii.fQo I/We certify under penalty of perjury that the above and foregoing information is true and correct. Signature of Applicant Date(month,day,year) • Address of Applicant number afid trf{ ed,city,state,and ZIP code) i-• P.),,,,,_- ,__J-04,, ,DI, - \--vt. L-J2-7 0 Signature of Authorized Rep .111k, \� Date(month,day,year) Address of Authorized Representative(number and street,city,state,and ZIP code) T Signature of County( Auditor o (�,\ .Q� ( 7 Date�lnnthTda year D ( N_'4 �eL_SL _ • �0 i \A,X A P^r'�i�`-'�/ . 1T� 1 1 .- ,f J c::IA(l/ J U L 21 202 ` - ;� . �iNg(\\ . DISTRIBUTION: Original—County Auditor; File-Stamped Copy—Taxpayer GIBBON COUNTY AUDITOR