HomeMy WebLinkAboutHomestead_RaineyFOflM HC 10 19i9 -
Pre5ai0ea By S�aie BoarO al ia. Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 �`j
ia & FileO in Duplitdte
SEE BACK FOR FILING INSTRUCTIONS
�(We) '"�^�� ���� '� � R''�'�-�-� v'-�-�-� certify that on the 1st day of
�vlarch, 19��_, I, ( e) o cupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) � owned DD� Q��p�
❑ are buying under contract
O have a beneficial interest in the taxpayer
Property Description in �—�—�'-°-^� County ��^ Township
Taxing District (C`�ewn, Township): Q�+�--
Parcel Number or legal description shown on tax statement:
• �d. �ruJ ��y /i- z-�� ��.9)
Ii buying Ofl contract: Owners name ��� s�mo�e owneq
Contract recorded in Recorders Office - Record N
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
naaress
County
Township
Caae
C7
' Individual either owns or is buying under a contraot that provides he is to pay the property taxes
on the residence, or has a bene(icial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
True Cash Assessed Homestead
Value Valuation Valuation
Land not exceeding 1(one) acre immediately
surrounding residenlial improvements
Other Land � � � �
Total Land �
Residential Improvements , �$ 1919_ Dwe��in
�uN 9
Garage
� ������� Total
Other Improvements �� pUpITOR
T�'-` Improvements - Li� (6) plus (7) equals (8) ,
I�aby certify,the above is true. correct. and compiete.
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