Form Pt 46b - Application For Paraplegic Property Tax Reduction Page 2
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4. Verification
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TO BE COMPLETED BY MEDICAL DOCTOR
__________ I hereby certify that the above individual is a paraplegic.
__________ I hereby certify that the above individual has suffered the loss or loss of use of both lower extremities
_______________________________________________MD
_______________________________________________
_______________________________________________
Address
TO BE COMPLETED BY COUNTY AUDITOR
A. Income
$_____________________
B. Percent Reduction Due
$______________________
C. Property Taxes (2002 payable 2003)
$______________________
D. Amount of Reduction (B x C)
$______________________
(Applies to 2003 taxes payable 2004)
PT 46B (5-02)
Original to Director of Equalization
Copy to applicant
PRINT FOR MAILING
EXIT
CLEAR FORM
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