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,„ "'r' APPLICATION FOR SENIOR CITIZEN - . . - IP YEAR
;(.1; t' PROPERTY TAX BENEFITS ,.�,
State Form 43708 (R19 / 7-25)
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•'C,... Prescribed by the Department of Local Government Finance
Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-35-9. DEC 08 2025
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 with the county auditor or postmarked by Janua of t e c e9053r yin
which the property taxes are first due and payable. C 6 ,1/V,246.,24)
GIBSON COUNTY AUDITOR
See reverse side for additional instructions and qualifications.
Type of Benefit Requested (Please check all that apply)
4E ver 65 Credit Over 65 Circuit Breaker Credit
ame ofApplican� wrle or tract u e )
Owned with Joint Tenant or Tenant in Common. Indicate with Whom
l'"fes ❑ No
If Name on Record is Different than Applicant. Indicate Below Do All Joint Tenants or Tenants in Common ide on the Property?
Yes ❑ No
Name of Contract Seller Has Applicant Owned or Bought the rope Under Recorded Contract
for at Least One(1)Year before Clacm g Cr�dtt?
Yes7. ❑ No
Address of Contract Seller (number and street. city. state, and ZiP code) Is the Pro erty in Question.
eal Property ❑ Mobile Home (IC 6-1.1-7)
Taxi g District r Key Number/ Legal Description Record Number Page Number
0/6 - / 7 -/A - eoi- 49.oe) . ,2 Vi - 04 Pt—
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 individual's homestead property in the immediately Yes ❑ No
preceding calendar year) and does Applicant qualify for the homestead standard deduction in the current year? ..-
Is the Applicant 65 Years of Age or More on December 31 of the Year Prior to the Year Taxes are First Due & Payable? 'Yes ❑ No
$
I/We certify under penalty of perjury that the above and foregoing information is true and correct.
xi, Signatur of Applicant Date (month, day, year)
Address of Applicant (number and street, city, state, and ZIP code)
N/
Signature of Authorized Representative Date (month, day, year)
Address of Authorized Representative (number and street, city, state. and ZIP code)
Signature of County Au itor Date (month, day. year)
ZA--)01.-- 11-''j / /9-(----- i a, — E - )_ 5
DISTRIBUTION: Original - County Auditor; File-Stamped Copy — Taxpayer