HomeMy WebLinkAboutHomestead_Powers�
CLAIM FOR H(X�'�STEAD PROPERTY TAX CRQIIT FOR YEAR 19 �q
SEE BACK FOR FIL1N6 INSTRUCTIONS
I�`���e� ��y,ds ��� [{J,1- m�.LtLA�t� � oertify that.on the lst day of
�+--�h, 19 , I, (we) occimied as our princinal ce of residence the followinq described real
�.p�-ty for wnich a Fiomestead ?roperty Tax �it is hereby being claimeri:
I, �'�') �'�'n�
� are buyinq urrier �ntract
� have a beneficial interest in.the taxnayer
Prorpsty Description in G/ Q sd'A�
Taxing District (City, Toom, hip)
{�D�v-0�549
Qowity �TOK/4 �mship
n�rc�l ti�a�L,er or legal des¢iption shown on tax statsrent:
�T. GJ ��S /�.IW'�a- 9- s.- i e �. o�.
If buvina om m�tract: Owners nan�e (fee simole owner)
� J Contract recorded in Re�n3er's Office - Record No. Page
Z* any portion of the residential structure or the land, not e�eeding one (1) acre that
imnecliately surroiuris that structise is used to produce incane� describe the use aczi portion of
the orooerty utilized to pmduce income
Pny other counties in which individual aans or is buying real property:
T :reby certify the above staterent is true, wrrect ani con�lete.
�.
Coimty Zb4mshiP
city, state ani zip a
*Tnrli�3ua1 eiti�r v�ms or is buying imer a wntract that provides he is t� pay the
praperty.taxes on the residence, or has a beneficial intex'est in the t� Tayer. ..
- FOR ASSESSOR�S USE ONLY -
True Cash
Value
iarr3 not exceeding 1;one) acre inmediately S'O O
surro�ing residential impzovanents (1)
• - . ,.
Total Iand
?,esidential I�rovelrents
�� ����
� •. I�roverrnts - Line (6) plus
I hereby certify the ai�ove is true,
Dwelling
Garaae
��i
(2)
(3)
(4)
(5)
/7 e
(o % O
3 ►Se a
�
c6� 3 /Soe
c�� —
c�� �5 ca> ca� 3► So 0
correct, and omg�lete.
- ACTION BY P.UDITf1R -
�o*_ov2d: Date:
Assessed
Valuation
/70
So
,
�������/
�������
. ._ . .
�� %%�'%//
,,,..�.,,.,.//.
, _ ��%���r/
��
F�esteacl
Valuation
/70
I)aa �