HomeMy WebLinkAboutHomestead_Nelson (7)wen+ Hc io iern
HescriDM By State BmrE ol Tax Commissioners
To & FileG in Duplitate
CLAIM FOfl HOMESTEAD PROPERTY TAX CflED1T FOfl YEAR 19�
SEE BACK FOR FILING INSTRUCTIONS
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�(We) /u�-o-�--�� �-e-� '"��-�-�-�-� - certify that on the 1st day of
��rarch, 19�L, I, (We) �occupied as our incipal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned 11f)� -OI(l(��
❑ are buying under contract ����
❑ have a beneficial in erest in the taxpayer
Property Description in ��-.�� County ��-�- Township .
Taxing District (G+by--Fewn, Township): �Q-�--��-
Parcel Number or legal description shown on tax statement:
�.,�. oSUJ �t� it/F �-[ 3- � -ic (" 82.4%
If buying on contract: Owners name ��ee s�mo�e ow�e�r
Contract recorded in Recorders Office - Record
If any portion of the residential structure or the land, not exceeding one (t) 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
� �J�� c1 l�.�, x� a
County
Township
ana
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
�U� ? 4 1979
Dwelling
Garage
�� �� Total
Other improveme' � ��""-�4�C.oi1>
Tr�-' Improvements - Line (6r•{i�� equals (8)
I�qy certify the above is true. correct, and complete.
Siqruwre ol nssessor
True Cash
Value
(1) �oo
(p) E,l� /2c
(3) �'S�
(q) %a So
(5) i s� 7 0
�6� g,7ao
(�) —
(s) S 7�-0
�t����l<C�Q��/irC��i�
Assessed
Valuation
Homestead
Valuation
�
/S
(o- ii-
Date
7
Approved: � q ��o-ti�- �z Date: __�—/s �,�