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--70t 1.V___ :C.'-`T"r• .P APPLICATION FOR SENIOR CITIZEN COUNTY TOWNSHIP YEAR � ! -- PROPERTY TAX BENEFITS StateForm43708(R19/ 7-25)Prescribed by the Department of Local Government Finance (JU :::f "��CJ ` 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 check*that apply) Over 65 Credit er 65 Circuit Breaker Credit Name of Applicant (owner or contract buyer) Telephone Number Email Address 'b't 11.,,c., e_Qs, Alms (8 Q ) L0-n - R r:_>( s Is Applicant the Sole Legal or Equitable Owner? If No. What is Applicant's Exact Share or Interest? If Owned with Joint Tenant or Tenant in Common, Indicate with Whom ❑)(eS ❑ No It Name on Record is Different than Applicant, Indicate Below Do All Joint Tenants or Tenants in Common Reside on the Property'? 1;1 Yes ❑ No Name of Contract Seller Has Applicant Owned or Bought the Property Under Recorded Contact for at Least One(1)Year before Claming Credit?„ es ❑No Address of Contract Seller (number and street, city, state, and ZIP code) Is the Property in Question 0 Real Property 0 Mobile Home(106-1.1-7) Taxing Distnct Key Number .�/Legal Description � I Record Number Page Number (2 cot 10_ 1. - t --• Did Applicant qualify for the homestead" tandard deduction n the preceding year (or was applicant married at the time of death to a deceased spouse who qualified estead standard deduction for the individuals 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 Pnor to the Year Taxes are First Due& Payable? Q4 s ❑ No Applicant's Date of Birth(month, day, year) If Filed by a Surviving, Unmarried Spouse.What Was the Spouse's Age at the Tine of Death? 1a- \-1 - -1 . Source of Income Amount of Income Adjusted Gross Income(AGI) of applicant, applicant and spouse, or applicant and joint tenants or tenants in common, as applicable (For Over 65 Credit, AGI ^may not exceed (1) $60,000 for individuals who filed a singe return, (2) S70,000 for i!:' ,( C ) - individuals who filed a joint return;or(3) $70.000 for Individuals and at others that $ , share ownership as joint tenants or tenants in common For the Over 65 Crcud Breaker Credt. AG!may not exceed_: (1)560.000 for individuals who filed a single C Di $ `�return, or(2)S70.000 for individuals who filed a pant return mth the rxlivxkiars ( v 1 - spouse.)[Beginning with Pay 27, ncorrie amounts for the Circuit Breaker Credit are annually adjusted_)See reverse for details. TOTAL S -, I/We certify under penalty of penury that the above and foregoing information is true and correct. Signay of Applicant Date month, day, year) / Z_c.4. — / //7A- - Di -a . of Applicant (nu r and'trees, acie, and ZIP code) 'D tom• '(Ma il:\ . r. t03A_10,--NcA- i-1 - '-i df2C Signature of Authorized Representative Date (month, day year) I Address of Authorized Representative (number and street, city, state, and ZIP code) Signature of County Auditor - Date (month, day, year) tILED o * D a -- 17 FEB 2 7 2026 je7s) • DISTRIBUTION: Original - County Auditor; File-Stamped Copy - Taxpayer t-i,24,c.izA„,2 GIBSON COUNTY AUDITOR INSTRUCTIONS AND QUALIFICATIONS GENERAL INSTRUCTIONS, • Applications must be filed during the specified periods. Once the application is in effect, no other filing is necessary unless there is a change in the status of the property or applicant that would affect the applicable credit. • This application may be filed in person or by mail. If mailed, the mailing must be postmarked on or before the last day of filing. • Any person who willfully makes a false statement of the facts in applying for these credits is guilty of the crime of perjury and on the conviction thereof will be punished in the manner provided by law. . • Being absent from the property while in a nursing home or hospital will not prevent a person from receiving these benefits. • The applicant must have been the owner or contract buyer of the property for at least one year prior to claiming the credit and must own the property or is buying the property under contract on the date the credit is claimed. The contract must be recorded and provide that the applicant is to pay the property taxes. BENEFITS • For the Over 65 Credit, the credit amount equals $150. However, where an applicant owns or is buying the property with joint tenants or tenants in common and not all the tenants are at least sixty-five (65) years of age, the credit is to be reduced by a fraction. The numerator of the fraction is the number of tenants who are not sixty-five (65) years of age, and the denominator is the total number of tenants. This reduction does not apply if the property is owned only by the applicant and the applicant's spouse. ti - - I , f , .3 • For the Over 65 Circuit Breaker Credit, the credit equals the tax liability minus the product of tax liability for the preceding year multiplied by 1.02. ELIGIBILITY • For the Over 65 Credit, Adjusted Gross Income (AGI) for the calendar year preceding by two (2) years the calendar year in which the property taxes are first due and payable may not exceed: (1) $60,000 for individuals who filed a single return; (2) $70,000 for individuals who filed a joint return; or (3) $70,000 for individuals and all others that share ownership as joint tenants or tenants in common. For the Over 65 Circuit Breaker Credit, the Adjusted Gross Income (AGI) for the calendar year preceding by two (2) years the calendar year in which the property taxes are first due and payable may not exceed: (1) $60,000 for individuals who filed a single return; or (2) $70,000 for individuals who filed a joint return with the individual's spouse. (E.g., to receive either credit for Pay 26, the individual's 2024 AGI must have been below the applicable threshold.) • Income amounts for the Over 65 Circuit Breaker Credit are adjusted annually by an amount equal to the percentage cost of living increase applied for Social Security benefits for the immediately preceding calendar year. The income threshold adjustment for the applicable year can be located at: httos://www.in.aovldlaf/deductions-property-tax. • Applicants must be at least sixty-five (65) years of age on or before December 31 of the year preceding the year in which the credit is claimed. For the Over 65 Credit, the applicant may be a surviving, un-remarried spouse, at least sixty (60) years of age on or before December 31 of the year preceding the year in which the credit is claimed, provided the decedent was at least 65 years of age at the time of death. The surviving spouse must otherwise satisfy the eligibility requirements for the credit. • For the Over 65 Circuit Breaker Credit, applicant must have qualified for the homestead standard deduction in the preceding calendar year (or was 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 preceding calendar year) and must qualify for the homestead standard deduction for the same homestead property in the current year. Y��