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HomeMy WebLinkAboutHomestead_Hyneman (2)ea 9� S:a e tlaa a oi a. Go n n ssionea CLAIM FOR HOMESTEAD PROPERTY TAX CREOIT FOR YEAR 19 �� ✓ SEE BACK FOR FILING INSTRUC �J� /) '<d°`,"' .(we) � " n, � . . . _ srch, 19—� I, (We) occupied as our principal place of residence hich a Homestead Property Tax Credit is hereby being claimed: ' ((We) ❑ owned \ � ❑ are buying under contract ❑ have a beneficiai interest in the taxpayer o �. Property Description in � -�-Q� � Taxing District (��r�� r��.�n Township): Parcel Number If buying on contract: Owners name "re ""'°1e �ePtify thai on the 1st day of Ilowing described real property for b06 -bDSal nty Ou-�--k-�-- Township or legal description shown on tax siatement: ��L� �.� �-� G Contract recorded in Recorders Office - Record No. Page � If any portion of ihe residential struciure or the land, noi 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 properiy: � hereby certify the above statement is true, correct and complete. �� � :� � �-t-_ . , a� � ��o „ �-�.,,, , � R � i�� ;. County Township �,� 70 � i 'Signamre � Suret nm�efs ' � �%/�ace anc Zio �de ' �- t-�, � Y 7 y ' Individual either owns or is buying under a contraci that provides he is to pay ihe property taxes on the residence, or has a beneficial interesi in the taxpayer. - FOR ASSESSOR'S USE ONLY Land not exce ng (one}� acre,immediately � surrounding re�enti� imp��ovem.�ts ��� Other Land Total Land _�!;�? :f i�;�i Residential Improvements Dwelling %//' ! "_L�__ � " Garage Ji , � l ��i.�; :` �t: � p�;-;±';;�;, Total Other Improvements Tr��� Improvements - Line (6) plus (7) equals (8) aby certify ihe above is true. correct. and complete. r �„ ` � _ ' -"� `,"-r't�-°-'� $iOM�u/e` O: ASSe530r True Cash Value ��> aa�� (2) — (3) 02 a (c o (a) a s 2 i o �5) � (6) � S.2 i c (�1 — �8� a sa . o - ACTION BY AUDITOR - Assessed Valuation 7 Sc � - � - o,:,• Homestead Valuation 7Sc � , Date: —�P=�G=_/ �—