HomeMy WebLinkAboutAge_Thompsom - ---
,,` R.",.. APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR
. PROPERTY TAX BENEFITS
. State Form 43708(R19/7-25)
Q/‘( 0 Z3 =c 2_
......_.
w• " Prescribed by the Department of Local Government Finance
Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-35-9.
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 January 15 of the calendar year in
which the property taxes are first due and payable.
See reverse side for additional instructions and qualifications.
Type of Benefit Requested (Please heck all that apply)
Over 65 Credit ver 65 Circuit Breaker Credit
Name of Applicant(owner or contr ct b er)
If Owned with Joint Tenant or Tenant in Common, Indicate with Whom
iu Yes ❑No
If Name on r ec• d is Different than Applicant, Indicate Below Do All Joint Tenants or Tenants in om on Reside on the Property?
Yes ❑ No
Name of Contract Seller Has Applicant Owned or Bought the rty Under Recorded Contract
for at Least One(1)Year before Claimi redit?
Yes ❑ No
Address of Contract Seller (number and street, city, state, and ZIP code) Is e roperty in Question.
Real Property ❑ Mobile Home (IC 6-1.1-7)
Taxing District Key Number/ Legal Description Record Number Page Number
Q . 2 -11 - CI_7}zA4 --ooa. 4 g - 2-g .
Did Applicant qualify for the homestead standard deduction in the preceding year (or was applicant married at the time of death t
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?
$
I/We certify under penalty of perjury that the above and foregoing information is true and correc .
Signs of Appli nt D mo h, e
)(
A dress or pelican umber and street, city, state, and Z de) 4. AN 13 2026
7 5--- E EpPile, 0,-\ -,
--'‘''`
Signature of Authorized Representative T Date (month, day, year)
IhAsubd a viretEfin24)
i e (number and street, city, state, and ZIP code) IJ NTY AUDITOR
Address of Authorized Representative vY GIggQN C
(q...1)
Signature of C my Au itor Date (month, ay, ye r)
P1 ,iki \
C 113 C .
DISTRIBUTION: Original - County Auditor; File-Stamped Copy - Taxpayer