HomeMy WebLinkAboutHomestead_KlenckFOPM HC 1U 1979
P�esaibed By Slaie Boartl ot ia. Commissioners
io Be FileO in Du0liwte �
CLAIM fOR HOMESTEAD PROPERTY TAX CREOIT FOR YEAR 19�
SEE BACK FOR FILING INSTRUCTIONS
e���o�,-,.c �4i �,.� _ 1� l !� �-..,n . �e n� 3� . certify that on the 1st day of '
'``19 I, (We) occupied as our pnncipal I e of resid nce the following described real property for
.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 in� � �-�l� Coun
Taxing District (@itp-�ewa, Township): �
pe�-plliy
Township
Parcel�Number or legal description shown on tax statement:
� 1��' ���i.�uJ � .3s= � // /.�e.�
If buying on contract: Owners name "� �'"'o1e
Contract recorded in Recorders Office - Record No
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: County Township
I hereby certify the above statement is true, correct and complete.
��" �/ BOX /9/ 7 70
J
'Siqnaw ` Sueet AOOress Cny. Siate antl Zip Cotle
' 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
Garage
Total
Other Improvements
��'. �:�:
Signawre ol nssezsor
Approved:—
ents - Line (6) plus (7) equals (8)
�": above is true. correct. and. complete.
True Cash
Value
(i) Soo
(2) —
(3) ,� O O
�a� a � 90
�s� a s�o
�6) m 9 3 0
(�) 5 7 O
(g) � �o 0
- ACTION BY AUDITOR -
Assessed
Valuation
/70
/70
�l '%
��
�.Z l O
oa,�
Homestead
Valuation
Date: 3 / / �3