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Age_Gibson Ili." • I } =' � APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR 7gt,`.'"I PROPERTY TAX BENEFITS ix k.`. 'le State Form 43708(R16/1-23) O , ` - ` - 95 'O1B4fr 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 wheys 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. k LA t CO t Type of Benefit Requested(Please chec all that apply) Over 65 Deduction from ` dress cal ibso� ��©. cap►-,' Gibson., St,°Ffre j A /©a, i'%c�a) L. , QC °� Is Applicant the e Legal or Equitable O er? If No,What is His/Her Exact Share or Interest? I Owned with Joint Tenant or Tenant in Common,Indicate with Whom iLJ' Yes ❑ No If Name on Record is Different than Applicant,Indicate Below Do All Joint Tenants or Tenants in Comma Reside on the Property? Yes ❑ No Name of Contract Seller Has Applicant Owned or Bought the Property Under R ed Contract for at Least r---,`P One(1)Year before Claiming Deduction? Yes ❑ No Address Irtract Seller(number and street,city,state,and ZIP code) Is the P operty in Question: 11``Pr LBS Real Property 0 Mobile Home(IC 6-1.1-7) Taxing District Key Number/Legal Description Record Number Page Number -P'oaata i o \j-t- -©g-1,0o-coo.1oc1-0 `7. Does Applicant Resi 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 es ❑ No Indiana real property]for the I es El No Have You Filed for Deduction in Any Other County? if Yes,What County? ❑Yes IYNo I/We certify under penalty of perjury that the above and foregoing information is true and correct. Signature of Applicant Date(month,day,year) -e or,retgra--4,/,too-- (number and street,city,state,and ZIP co • N. 1 - 0� tom _ `-ki��0 - Signature of Authorized Repres nt Date(month,day,year) Address of Authorized Representative(number and street,city,state,and ZIP code) Signet a of county Auditor ` Date(mon \- e—iC1-51.---0 O' ' -5 - -�L a itED FEB 2 1 2025 ,....... DISTRIBUTION: Original—County Auditor; File-Stamped Copy—Taxpayer a GIBSON COUNTY AUDITOR