HomeMy WebLinkAboutHomestead_GehliOftM HC 70 1979
ReuriCeO By State BwrO ai Tu Commissioners
To & FiIM in Dupliwte
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 7�
SEE BACK FOR FILING INSTRUCTIONS
.(We) �"-X- `� certify that on the 1st day of
arch, 19�rL, I, (We) occupied as o pri cipal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned OQ(p -oo�aq
❑ are buying under contract
❑ have a beneficial inter st in the taxpayer
Property Description in ��'�°-�^ County ��'"��" Township
Taxing District (City�-Township): ��'���
Parcel Number
If buying on contract: Owners name ��re simo�e
or legal description shown on tax statement:
,� SE�% a�- � -�� �i�9�
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.
K�
svee�
County Township
Cicy. Sute ana Zio Wee
' 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
Tot�La�
Res ential Imp�em�s
�uN 2 5 ?9i9
Dwelling
Garage
Total
Other/��r/r��rov me S
To' ' �ftii pr �m n s - ���-��plus (7) equals (8)
I�oy ertiTy the above is true. correct. and complete.
Si9na[ure ot Asseswr
1
Approved
True Cash
Value
(�j �o 0
(2) �
(3) � O-a
(4) / S 9 So
�s� —
�s) / s 9 Sa
(�) �
�g� /S9 So
- ACTION BY AUDITOR -
Assessed
Va�uation
/ 70
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,�
•
Homestead
Valuation
/ 70
�— i— 7P
Da:e
Date:
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