Disabilty_Whitlow -�""4. APPLICATION FOR CREDIT AGAINST PROPERTY COUNTY TOWNSHIP YEAR
- I;', TAXES FOR BLIND OR DISABLED PERSON
� State Form 43710 (R15! 7-25) Gibson Princeton 2025
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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 located.
Filing Date. Form must be completed, signed, and filed by January 15 of the calendar year in winch the property taxes are first due and payable
See reverse side for additional instructions and qualifications.
Name of Applicant(owner or contract buyer)
with Someone Other than Spouse, Indicate with Whom
Q Yes ❑No
If Name on Record is Different than that of Applicant, Indicate Below
Name of Contract Seller Address Of Contact Seler(number arid sfree( city,state,and ZIP code)
Is the Property in Question Is Applicant Blind(as defined in IC 12-7-2-21(1)p
Q Real Property ❑ Mobile Home (IC 6-1 1-/) ❑Yes 0 No
is Applicant Disabled and Unable to Engage in Any Substantial Gainful Actmty? Is the Property Used and Occupied Primarily for HtsMer Residence?
El Yes 0 No 0 Yes 0 No
Taxing District Key Number/ Legal Description Record Number(contract) Page Number(contract)
Princeton 26-12-07-401 -002.210-028
I/We certify under penalty of perjury that the above and foregoing information is true and correct
Srgnatuy of 'cant Address of Applicant (number and street, city. state, and ZIP code)
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4;11: / t/ .._----- -- - 326 E. Water St. , Princeton , IN 47670
ure of Authorized Representative Address of Authorized Representative (number and street, city, sr,ite and ZIP code)
RECEIPT FOR APPLICATION FOR CREDIT FOR BLIND I DISABLED PERSONS
Name of Applicant Date Filed (month at/4 )
Jeffrey Whitlow
Name of Contract Seller
N/A
J A N 1 4 2026
,5zeTaxing District
Princeton /�
Key Number/Legal Description (thz zz� &. �'toerind)
26- 12-07-401 -002 . 210-028 GIBSON COUNTY AUDITOR
Signature of County Auditor Dale Signed (month, day, year)
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