HomeMy WebLinkAboutDisabilty_Buyher Is' �"h APPLICATION FOR CREDIT AGAINST PROPERTY.� COUNTY TOWNSHIP YEAR
it . . � TAXES FOR BLIND OR DISABLED PERSON '
K '1 Stale Form 43710 (R1517.25)
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Prescribed bythe Department of Local Government Finance
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Instructions: To be filed in person or by mail with the county auditor of the county where the property is local' .
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. )
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Is p icant the Sole L a or E tV\eA
ner? 1, If No, What is the Applicant's Exact Share or Interest?� � �� IfOwned with Someone ether than Spouse, Indicate with Whom
EYes 0 No
If Name on Record is Different than that of Applicant, Indicate Below:
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Name of Contract Seller Address of Contract Seller(num r and street, city, state, and ZIP code)
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Is the Property in Question. Is pp scant lind (as defined in IC 12-7-2-21 1
Real Property 0 Mobile Home (IC 6-1.1.7) Yes DNo
Is • '' • ' Unable to Engage in Any Substantiale 694 , d Prim ily fo is/Her Residence?
GI ;SON COUNTY AUDITOR
TA Yes 0 No
es INo
Taxing Dis Id r.. Key Number I Legal De ription Record Number ( ntrac Page Number(contract)
oD uu,/,,\,, ,*
V
oo s -.00
INVe certify under penalty of perjury that the above and foregoing information is true and correct.
Sign u e of Applicant Address of Applicant (number and street, city,state, and IP e)
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Signature of Authori ed Representati Address of Authorized Representative (number and street, city, state, and ZIP cod:)
To Whom It May Concern:
Phillip Buyher, is legally blind in both eyes. Feel free to contact my office if any questions.
Sincerely,
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