Homestead_ThompsonF9RM HC 10 7979
heuriDeE By SWte BoarE of Ta. Cammiuioners
To & FileU in Dupliwie
CLAIM FOR HOMESTEAD PHOPERTY TAX CREUIT FOR YEAR 19 �%
SEE BACK FO
�(We) '����^ ��r "'""-"' O. v � certify that on the 1st day of
arch, 19� I, e) occupi d as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed: •
I, (We) D owned b� /��C�(��
❑ are buying under contract ��
,❑ have a beneficial intere/st! in� the taxpayer
Property Description in �"w-^ County ����z-<- Township
Taxing District (6rty�awn, Township): �a--��-
Parcel Number or legal description shown on tax statement:
�j � S'E �/y �CU�/.i 3- Z -�o �a.✓�,a)
If buying on contract: Owners name ��� �m01e °'""e`�
Contract recorded in Recorders Office - Record
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
� hereby certify the above statement is true, correct and complete.
S� � �--- r� 2 ,� � � 6
ign mre Sneet AOareu Ciry. Sta�e ana Zip Coee
' 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 -
True Cash
� Value
Land not exceeding 1(one) acre i�nmecgatelyd '
surrounding residential improvements � � (�) �� °
other Land ��� 1 c� �p79 (2) ' 7 0
Total Land (3) �� °
Residentiai Improvements
Other Improvements
� � • %:
� •�'
' 319 �y.
�.
Tr�� '� .-�provements - Line (6) plus (7) equals (8)
I!!#'9y certify ihe above is true. correct. and complete.
Signature ol Assessor
(a� 5 s 9 0
(5) —
(6) S 89a
(�)
�8� SB�i �
- ACTION BY AUDITOR -
Assessed
Valuation
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Homestead
Valuation
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Date: G -/�- 79