HomeMy WebLinkAboutDisabilty_Boop 4�' 1 APPLICATION FOR CREDIT AGAINST PROPERTY
;. TAXES FOR BLIND OR DISABLED PERSON COUNTY TOWNSHIP YEAR
. "--i'll, State Form 43710 (R15 / 7-25) �� r)
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Prescribed by the Department of Local Government Finance
Instructions: To be filed in person or by mail with the county auditor of the county where the property is loca .
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.
Name of Applicant (own r contract buyer)
Owned with SomeonpbUt�` th n Spouse, Indicate with Whom
/ � 7 2025
Yes El No
If Name on Record is Diff ent than that of Applicant, Indicate Below:
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Name of Contract Seller Address of Contract Seller(number and street. city, state, and ZIP code) ����`AUDITOR
Is the Property in Question: Is Applicant Blind (as defined in IC 12-7-2-21(1))?
Real Property ❑ Mobile Home (IC 6-1.1-7) ❑Yes No
Is Applicant is led and Unable to Engage in Any Substantial Gainful Activity? Is the Property Used and Occupied Primarily forqies
His/Her Residence?
76Yes D No n No
Taxing District Key Number/Legal Description Record Number (contract) Page Number (contract)
1-
me certify under penalty of perjury that the above and foregoing information is true and correct.
S rat ' e of Applicant Address of Applicant (number and street, city, state, and ZIP code)
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Authorized Representative Address of Authonzed Representative (number Ind strieet, city, state, and Z10 code)
RECEIPT FOR APPLICATION FOR CREDIT FOR BLIND i DISABLED PERSONS
Name of licantrTh: Date Filed (month, day, year)
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Name of Contract Seller FI
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Taxing District / 2025.
DEC 1 7 202
CBOT - �I 6r0 C-A
Key Number/Legal Description
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GIBSON COUNTY AUDITOR
Signature of County Auditor Date Signed (month, day. year)r
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