This government document is issued by Dolores County for use in Colorado
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https://www.google.com/url?client=internal-element-cse&cx=30e844f92a4dd4624&q=https://dolocnty.colorado.gov/sites/dolocnty/files/documents/Senior-Exemption-Short-Form-Instructions.pdf&sa=U&ved=2ahUKEwi1jYqYr7CHAxXviP0HHYBlBFY4FBAWegQIABAB&usg=AOvVaw28qDq3OoCsOH138UG8TJeJ&fexp=72519171,72519168