HomeMy WebLinkAboutAge_Peterson -''` ►T,..� APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
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PROPERTY TAX BENEFITS
State Form 43708(R19/ 7-25)
Gibson Princeton 2025
"�• Prescnbed 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 marl with the county auditor of the county where the property is located
Filing Date: Form must be completed, signed. and tiled with the county auditor or postmarked 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
Type of Benefit Requested (Please check all that apply)
Q Over 65 Credit Over 65 Circuit Breaker Credit
Name of Applicant (owner or contract buyer)
Owned with Joint Tenant or Tenant in Common, indicate with Whom
Yes ❑ No
It Name on Record is Different than Applicant. Indicate Below Do All Joint Tenants or Tenants to Common Reside on the Property-'.'
I Yes f No
Name of Contract Seller Has Applicant Owned or Bought the Property Under Recorded Contract
for at Least One(1)Year before Clarmng Credit?
N/A p Yes ❑ No
Address of Contract Seller (number and street. city, slate, and ZIP code) Is the Property in Question
N/A _ Q Real Property ❑Mobile Home(IC 6-1 1-7)
Taxing District Key Number / Legal Description Record Number Page Number
Princeton 26-12-07-104-001 .264-028
Did Applicant qualify for the homestead standard deduction in the preceding year (or was applicant married at the time of death to
a deceased spouse who qualified for a homestead standard deduction for the indrviduat's homestead property in the immediately ❑1 Yes ❑ No
preceding calendar year) and does Applicant quality for the homestead standard deduction in the current year?
spouse.)[Beginning with Pay 27, ncome amounts for the Circuit Breaker Credit are
annually adjusted j See reverse for details. TOTAL $
I/We certify under penalty of perjury that the above and foregoing information is true and correct.
Signature of Applicant Date (month, day, year
13\SIVINCla )
Q-+Q /0/11 ? .1/
Address of Applicant (number and s , city, stalk, and ZIP code)
303 W. Walnut St., Princeton, IN 47670
Signature of Authorized Representative Date (month, day, yegrT
S
Address of Autfianzed Representative (number and street, city, state, and ZiP code)
Gies •
Signature of County Auditor0.
Date (month, day, yparj1ry7-)7A `�QJ
CLAY 0 mot. - ) { ' R
DISTRIBUTION: Onginal - County Auditor; File-Stamped Copy - Taxpayer