HomeMy WebLinkAboutHomestead_Hardiman (12)wnn� Hc m iem
hescri�e0 By State BWrd o� Taa Cammi55ioners
To Be FileG in Duplitate
CLAIM FOR HOMESTEAO PROPERTY TAX CAEDIT FOR YEAR 19 7y
SEE BACK FOR FILING INSTRUCTIONS
�(we) /�-�-�.-a�--�---, �--�--�� 7�� �' �����--�e- certify tnat on tne ist day ot
arch, 19�, I, (We) occupied as our principal place of residence the tollowing described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) �_ owned
are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Taxing District (City-�ewn, Township): u'
Parcel Number
If buying on contract: Owners name �'� �""v'° °°"ef�
DD�'Ob7��
��'�-�-- Township
or legal description shown on tax statement:
� � �o�.. �oy�
�E �u 9-� -�i
Contract recorded in Recorders Office - Record No. Page
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.
Aeeress
County
0
u
Township
�,�--�r� � �k��
City. State an0 Zip CoGa
' 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 immediatel
surrounding residential improv�n� � � �
Other Land
Total Land
JU1V � � i979
Residential Improvements Dweiling
�Q� ae
�� � AUDIi�I
Other Improvements
To �' Improvements - Line (6) plus (7) equals (8)
I;�by certiiy the above is true. correct. and complete.
Sgnamre of Asseswr
True Cash
Value
(1) �co
�2� a��9c
�s� „? 8 I 9 0
c4) / 9 � So
�5� �-- _
(6) j=� % g D
(�> 9�30
�8� a9� 30
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
��'o /3
�
�-�-�y
Da:e
Date: �((J�
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