HomeMy WebLinkAboutHomestead_Tryonwaln xc m iern
PreSCriEeE By State BoarE of Taa Commissioners
CLAIM FOH HOMESTEAO PROPERTY TAX CREDIT FOR YEAR 19 � y
To & Filed in Ouplicate
SEE BACK FOR FILING INSTRUCTIONS
� (We) � - � � � � � � • certify that on the 1st. day of
��larch, 19� cupied as our princip place o residence the following described real property tor
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) �.owned O/�/_ �D� q9�
❑ are buying under contract V10
❑ have a beneficial interest in the taxpayer
Property Description in „� County v�- Township
Taxing District (Cii�,-�ewrr, Township): ���%z-a-
Parcel Number or legal description shown on tax statement:
��. �W''� / 9- z -'° ��4.)
If buying Ofl contract: Owners name ��� simv�e owner�
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.
�.� � • ���— � �/r-�/ o,iu�
s«��
ury. sinte ana cip CoCe
' 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 7(one) acre immediately
surrounding resitlential improvements
Other Land � � � � �
Total Land �
Residential Improvements �UN 2 5 1979
- Dwelling ,
Other Improvements
G�age
� /�� //
� T,otal>
AliDI70R
T�� ' Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct. and complete.
Sigiumre ot Azsessor
Approved
True Cash Assessed Homestead
Value Valuation Valuation
(1) ��c /'o
(2) —
(3) SO o
(a) �//o
cs� 900
�g� /v0 / G
�7� /.3 0
(g� l �/ 5� o
.
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� P30
Date
Date:
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