- Harrington, Janos_11/21/2024 .,'''`--'R4� A i= (0 U o COUNTY TOWNSHIP YEAR
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INSTRUCTIONS Wes ' arty is located.
Filing Date: •
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Q5 Circuit Breaker Credit
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Nam?of Apphcan (. � �Ld1t11 QDI 7,0 `� ss
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Is Applicant the ole .. -, . - — er Exact Share or Interest? If Owned with Joint Tenant or Tenant in Common,Indicate with Whom
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i - - No
If Name on Record is Different than Applicant,Indicate Below �� T� /. V Do All Joint Tenants or Tenants in Common Reside on the Property?
DISTRIBUTION: Original—County Auditor; File-Stamped Copy—Taxpayer