Age_Hightshoe "-"A APPLICATION FOR SENIOR CITIZEN —i
COUNTY TOWNSHIP
e.
YEAR
!�s ` PROPERTY TAX BENEFITS
IState Form 43708(R16/1-23) G l b Son Ic kncehon ay
'I,•.% 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 of Benefit Requested(Please check all that apply)
I
Over 65 Deduction from Assessed Valuation .._" ,--Over 65 Circuit Breaker Credit
I i
Name of Applicant(owner or contract buyer)
If Owned with Joint Tenant or Tenant in Common.Indicate with Whom
es L_ No
If Name on Record is Different than Applicant,Indicate Below Do All Joint Tenants or Tenants in Common- Reside on the Property?
L Ymoes 7 No
Name of Contract Seller Has Applicant Owned or Bought the Property Under Recorded 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 the Property in Question:
eat Property Ti.__, Mobile Home(IC 6-1.1-7)
Taxing District Key Number I Legal Description Record Number Page Number
t?c;Aiescon 26-i1-!8-1o1 '-on( 73o -oz -
Does Applicant Reside on Property? Assessed value of the
Have You Filed for Any Other Deductions? If Yes,What Deductions? FILED
( Yes ElNo �OMeS
Have You Filed for Deduction in Any Other County? If Yes,What County? -�
❑Yes ,o FEB 21 2024
•
I/We certify under penalty of perju at the above and foregoing information is true and co r t.
ti:-:::-::.N.' -,ii• -.-..i_i-L,......___ GIBSON �Oear/
Address of Applicant(number and str e)- .state,and ZIP code) 1
191 5 Tekw-e44n .,lU y 74 7 0
sentative
„ ! .. -�00.day.year)
.agAMINIMIlli, . > 9 I — i — ,f -
A..r-s4.f Aut
oozed Represent.ive(1 mber and street.city,state,and ZIP code)
V 0
Signature of Co my Auditor Date(month. day.year;
aa I/a
DISTRIBUTION: Original—County Auditor; File-Stamped Copy—Taxpayer