HomeMy WebLinkAboutHomestead_Dyer (3)FORh1 HC tU 1979
Prescri�eE By Siare Bw�O af,ia. Commissioners
to Be Filetl in Wplicaie
CLAIM FOR HOMESTEAU PROPERTY TAX CRE�IT FOR YEAR 19�`L
SEE BACK FOR FILING INSTRUCTIONS
�(We) ��� F�-''' ��ti certify that on the 1st day of
March, 19� I, (We) occupied as our principal plac of residence the following described reat property for
which a Homestead Property Tax Credit is hereby being claimed:
I. (We) C3'owned DD/„ .1'li,C � / _
❑ are buying under contract v� T/�/��'� v
� have a beneficiai interest in the taxpayer ,n
Property Description in � County '�1"�za-, Township
Taxing District (City, Town, Township): `-C-'!1_�a-�c� .�.�+o.
Parcel Number or legal description shown on tax statement:
PE. Nw'iu ,vw'�y ao-�-io �A.
If buying on contract: Owners name u� simple o.�en
Contract recorded in Recorders Office - Record
If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property:
�hereby certify the above statement is true, correct and complete.
1 9e��G a i y
County Township
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residential improvements
Other Land � � � � �
Total Land
Residential Improvements Dwelling
JUW ?, �� i979
Garage
�/��U, -� Total
Other Improvements /� AU�OR���
T�Improvements - Line (6) plus p) equals (8)
; by certify the above is true. correct. and complete.
Signawre oi
C%J
True Cash Assessed Homestead
Value Valuation Valuation
(1) I � s-u �iao
(2) —
(3) �a�
(a) . l� 9.�0
�s� —
(6) /�9�ao
�>> -
�s> i r 960
ACTION BY AU
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Date:
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