Disabilty_Lyon = '"- ...oa, APPLICATION FOR CREDIT AGAINST PROPERTY COUNTY TOWNSHIP YEAR
iii • : }, .1 TAXES FOR BLIND OR DISABLED PERSON
\ 'l State Form 43710(R15 17-25)
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Soli_�• 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 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.
Name,of Applicant (owner or contract buyer)
If Owned with Someone Other than Spouse, Indicate with Whom
KYes ❑ 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. Is Applicant Blind (as defined in IC 12-7-2-21(1))?
CgReal Property 0 Mobile Home (IC 6-1.1-7) ❑Yes ANo
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Is Applicant Disabled and Unable to Engage in Any Substantial Gainful Activity? Is the Property Used and Occupied Primarily for His/Her Residence?
Oyes ❑ No Yes ❑ No
Taxing istrict Key Number/ Legal Description Record Number (contract) Page Number (contract)
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I/We certify under penalty of perjury that the above and foregoing information is true and correct.
Signature of Applicant Address of Applicant (number and street, city, state, and ZIP code)
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Signature of Authorized Representative Address of Authorized Representative (number and street, city, state, and ZIP code)
RECEIPT FOR APPUCATION FOR CREDIT FOR BLIND / DISABLE O S
Name Applicant ( 1 Date Filed (m d , y r) ED
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Name of Contract Seller
DEC 1 5 2025 61 ; •
Taxing strict
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Key Number/Legal Description GIBSON COUNTY AUDITOR
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Signatur of County Auditor Date Signed (month, day, year)
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Notice of Award
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743 115532 **AUTOMIXED A.ADC 296 R P1 T4 M1 PC3 190807
'43 JOHN B LYON
tizt PO BOX 405 0
HAUBSTADT IN 47639
Your Benefits
We are changing the type of benefit you receive from Social Security.
g
Beginning July 2019, you are entitled to retirement benefits. You are no
longer entitled to disability benefits because you have reached full retirement
age.
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