Disabilty_Reed (2) Reset-Form
' > � APPLICATION FOR BLIND OR DISABLED PERSON'S COUNTY WNSHIP YEAR
a DEDUCTION FROM ASSESSED VALUATION
xy 66g0'f �K/
�-;. ., State Form 43710(R14!g-24) Qr
'•�• 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,signed,and filed by January 15 of the calendar year in which the property taxes are first due and payable.
See reverse side for additional instructions and qualifications.
Na pplicant(owner or contract bu_! &.... ..6
R
Is applicant the sole legal or equitable owner? If No,what is his/her exact share or interest? If owned with someone other than spouse,indicate with whom
Yes ❑No
If name on record is different than that of applicant,indicate below:
Name of Contract Seller
Address of Contract Seller(number and street,city,state,and ZIP code) Is the Property in Question:
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Is applicant blind as defined in IC 12-7-2-21(1)? Is applicant disabled and unable to engage in any substantial gainful activity as defined in IC 6-1.1-12-11(d)?
❑Yes ,dNo $Yes ❑No
Is the property used and occupied primarily for his/her residence? Does the applicant's taxable gross income for the preceding calendar year exceed$17,000?
,Yes ❑No XYes ❑No
Taxing District Key Number/Legal Description Record Number(contract) Page Number(contract)
Dag /....�id id g6-la-oE-10 -0.9z SoA- ?
I/We certify under penalty of perjury that the above and foregoing information is true and correct.
Signature of A 'cant ddress of Applicant(number and street,ci ,slate, nd ZIP code)
IA .1l.--1. M"/ 1;e7ALL NA( IQR1E t92/ArGCO ki 71d 4/76-7L
• ature of Authorized Representative Address of Authorized Representative(number and street,city,state,and ZIP code) /
RECEIPT FOR APPLICATION FOR DEDUCTION FOR BLIND/DISABLED PERSONS
Nam Applicant fq, n Date Filed(month,day,year)
Name of Contract Seller FILED
Taxing District MAY 0 9 2025 4.
OAg iiip
R/AiCE7 d 1
Key Number/Legal Description jr /((,GZ a. , d)
• l --O Q_./d(-- O gi gO e g? GIBSON COUNTY AUDITOR
Signatur of C,Qunttyy Auditorp Date Signed(month,day,ye )
/ / ..,g 97 6 610q C.1" 6—
I11/h
Notice of Award
0000645 00022231 2 MB 0.571 0229M3MCS5PI T156 P15
•4,t ROBERT R REED 8
107 FREDDIE ANN DRIVE
PRINCETON, IN 47670-3111
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