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APPLICATION FOR CREDIT AGAINST PROPERTY
TAXES FOR BLIND OR DISABLED PERSON,
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State Form 43710 (R15 / 7-25)
Prescribed by the Department of Local Government Finance
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TOWNSHIP
YEAR
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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 which the property taxes are first due and payable.
See reverse side for additional instructions and qualifications.
Name of Applicant (owner or contract buyer)
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Telephone Number
Email Address
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Is Applicant th64dle Legal Equitable Owner?
If No, What is the Applicant's Exact Share or Interest?
If Owned with Someone Other than Spouse, Indicate with Whom
,or
(.Yes ❑ No
If Name on Record is Different than that of Applicant, Indicate Below:
Name of Contract Seller
Address of Contract Seller (number and street city, state, and ZIP code)
Is the Property in Question:
Is Applicant Blind (as defined in IC 12-7-2-21(1))?
I Property ❑ Mobile Home (IC 6-1.1-7)
❑Yes
Is Applicant and Unable to Engage in Any Substantial Gainful Activity?
Is the Property Used and Occupied Primarily for His/Her Residence?
,Disabled
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Yes ❑ No
EYS ❑ No
Taxing District
Key Number / Legal Description
Record Number (contract)
Page Number (contract)
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lMe certify under penalty of perjury that the above and foregoing information is true and correct.
Signature of Applicant
Address of Applicant (number and street, city, state, and ZIP code)
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Signature of Alithorized Representative
Address of Authorized Representative (number and street, city, state, and ZIP code)
RECEIPT FOR APPLICATION FOR CREDIT FOR BLIND / DISABLED PERSONS
Name of Applicant
Date Filed (month, day, year)
FILE-1-0
Name of Contract Selle
MAY 0 6 2026��
Taxing
Keyy Number/ Legal Description
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GIBSON COUNTY AUDITOR
Signature of County Auditor
Date Signed (month, day, year)
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Notice of Cost -of -Living Adjustment (COLA)
Hello SHERILYNE S DREW
Your Social Security benefit will increase by 2.8% in January 2026. Next year, receive your benefit information
up to three weeks earlier by creating an online my Social Security account at www.ssa.gov/myaccount. You can
use this letter as proof of your benefit amount if you need to apply for food, rent, or energy assistance. You can
also use it to apply for bank loans and for other business. Keep this letter with your important financial records
or access this information anytime online by signing in to your personal my Social Security account.
How Much You Will Get In 2026 (Before Deductions)
Monthly Amount
Your monthly benefit in 2026 before deductions
$1,424.90
2026 Common Deductions
Monthly Amount
Medicare Medical Insurance (Part B and Part C)
-$202.90
if you did nofnave Meaicare as or November 20 20 50� it someone else pays your premium,—
----
we show $0.00.
Medicare Prescription Drug Plan (Part D)
-$0.00
We will notify you if the amount changes in 2026. If you did not elect withholding as of
November 1, 2025, we show $0.00.
U.S. federal tax withholding for non -citizens
-$0.00
Voluntary federal tax withholding
-$0.00
If you did not elect voluntary tax withholding as of November 20, 2025, we show $0.00.
How Much You Will Get In 2026 (After Deductions)
Monthly Amount
Your monthly benefit in 2026 after deductions
$1,222.00
This monthly amount may include deductions not listed above.
For more information about your COLA and other benefits -related topics such as
Medicare, Ticket to Work, Reporting Wages, Earnings Limits, Other Pensions,
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and more, go to www.ssa.gov/cola or scan the QR code.
If you would like a paper copy of any of this information, please contact us.
Need more help?
1. Visit www.ssa.gov for fast, simple, and secure online service.
2. Call us at 1-800-772-1213, weekdays from 8:00 am. to 7:00 pm. If you are deaf or
hard of hearing, call TTY 1-800-325-0778. Please mention this letter when you call
3. You may also call your local office at 1-877-768-5679.
SOCIAL SECURITY
2300 N GREEN RIVER RD
EVANSVILLE, IN 47715