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r APPLICATION FOR SENIOR CITIZEN
`� COUNTY TOWNSHIP YEAR
s.1 • i PROPERTY TAX BENEFITS
. ,,, State Form 43708 (R19 17-25) Gibson Pa to ka '
,..• Prescribed by the Department of Local Government Finance -
Information contained in this document is CONFIDENTIAL pursuant to IC 6-1.1-35-9 lik.. ...c 0
Instructions To be hied in person or by mail with the county auditor of the county where the property is located s►
Fifing 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 check all that apply) - 1 Mj( Ca,Q Over 65 Credit /t- iel\i) Q Over 65 Circuit Breaker Credit
Name of Applicant (owner or contract
mccandless.mark@gmail.com
Is Applicant the Sole Legal or Equitable Owner?-7 If No, What is Applicant's Exact Share or Interest'? tt Owned with Joint Tenant or Tenant in Common, Indicate with Whom
Q Yes ❑ No
It Name on Record is Different than Applicant, Indicate Below Do AN Joint Tenants or Tenants in Common Reside on the Property'?
Yes ❑ No
Name of Contract Seller Has Applicant Owned or Bought the Property Under Recorded Contract
for at Least One(1)Year before Clarnng Credit'?
El ❑ No
Address of Contract Seller (number and street, city. state, and ZIP code) Is the Property in Question
Q Real Property 0 Mobile Home (IC 6-1 1-7)
Taxing District Key Number / Legal Descnptron Record Number Page Number
PokicAunt- - 1-1�- t0i-- r)p3c't-Da, - 0a--7 . - .
Did Applicant quality for the homestead 1tandard 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 properly in the immediately Q Yes ❑ No
preceding calendar year)and does Applicant qualify for the homestead standard deduction n 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 8 Payable? El Yes ❑ No
I,We certify under penalty of perjury that the above and foregoing information is true and correct
Signature of Ap scant � Date (month, day, year)
AA . 01 /09/2026
Address of Applicant (number and street, city, state, and ZIP code)
2619 W Ju;ie Drive, Princeton, IN 47670
Signature of Authorized Representative Date (month, day. year)
01 /09/2026
Address of Authorized Representative (number and street, city, state, and ZIP code)
3248 E State Road 64, Princeton, IN 47670
Signature of County Auditor Date (month, da yeari LED
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, .
J A N 1 4 2026 ,,5,1--
DISTRIBUTION: Onginal - County Auditor, File-Stamped Copy - Taxpayer (7--/24 -e‘ a. x.6
GIBSON COUNTY AUDITOR