HomeMy WebLinkAboutHomestead_GreubelC�AIf� FOR H(�'�STEAD PROPERTY TAX CRQIIT FOR YEAR J�ii
SEE BACK FOR FILING INSTRUCTION �
I, ����e) ��EliLBEC. �FJllnlET�} W. E ��j eextify that on the lst day of
n, 19�, I, (we) occ�ied as our princioal olace of residence the following descri.bed real
�:�esty for which a Iiomestead ?roperty Tax �it is hereby �; *+; .claimed:
I, (S•7e) � cx�ma3
� are buyinq under wntract
� have a bene£icial interes
p::o�._rty Description in
Ta�cing District (City, Twm 'Ibc,mshi'
��
Parcel ihmibes (
in the tasu�ay
006 -Do �a a
�. � ' / . � . .
or legal des¢iption shown on tax statere�it:
�t�T. �.J �. n1E ��K IS �-/o �. 9y9
�..
If buvina on �ntract: Owners name (fee simole v„mer)
Contract recorded in RE�rder's Office - Record No. Page
If any portion of the residential structure or the land, nat e�eeding one (l) acre that
imnediately surroiu�ds that stn�ctise is used t+o produce i�cane, describe the use airi portion of
the pmperty utilized to pmduce income
Pny other counties in which individual owns or is buying real property:
Co� - . Ztr�+nship
�sehy certify the above statere�t is true, �rrect and cong�lete.
*Signature _• Street Address Cit]'. State az�d Zip Code
*Individual either aans or is buying tmer a oontract that provid�s he is tt� pay the
prapeity taxes on the residence, or has a beneficial interest in the ta�yer.
- FQR ASSESS(B2�S USE ONLY -
Land not ex�ing 1(ane) acre i�nediately
s�zotuxiing resiaenti.al i�mva[ents
•._— .,.
Total Iana
p�sidential 7nQrov�r�ents
Dwelling
Garaae
��i
q'rue Cash
Value
ci� ��o
(2) / 3 u
(3) �, 30
c4) 3S3 0
(5) �
c6) 3S3�o
Assessed
Valuation
.
///��/�����
�////�����
o`�ner Imoro�anents c�> �
� ' I�rov�nents - I.ine (6) pl,is (7) eQUats (6) (E) _3S3�o //780
I heseby certify the above is true, correct, anl amPlete.
lJ
Fworoved:
- ACTION BY Q.UDITnR -
Date:
L�te
Harest.ead
Valua�.on
/70
//780