Homestead_Turpin (7)FOflM HC /0 1979
PreuriOM By State Bwrd o� Taz fqmmissioners
To & FiIM in Duplicate
� CLAIM FOR NOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 � 9
SEE BACK FOR FILING INSTRUCTIONS -
�(We) �'�-��-�-�- �ahhM C- ���K-<--�-�- """%i- certify that on the 1st day of
�varch, 19?y I, ( e).occupied as our prin al place o esidence the fo lowing described real property for
which a Homestead Property Tax Credit is hereby being claimed: •
I, (We) ❑ owned Obb �d���7
❑ are buying under contract
O have a beneficial inteQr,e�st .in the taxpayer
Property Description in �-�-�-�^ County QO��L� Township
Taxing District (Citq; �ewn,--Township): �o��-p��
Parcel Number or legal description shown on tax statement:��
(p �. o�o-z- l07 1-io ��A)
If buying on contract: Owners name �'re "nip1e °""°`� �' ' �
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:
�hereby certify the above statement is true, correct and complete.
County
�
Township
�%!o (o C
aoa zio Caae
' 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 US
Land not exceeding 1(one) acre immediately
surrounding residential improvements _
Other Land � � � �
Total Land �
�
Residential Improvements Dwellin
JUfy � 91979 9
_ Garage
" /f��L�� Total
Other Improvements�, i � p�p ��R
��T�'-'�Improvements - Li (6) plus (� equals (8)
ay certify the above is true. correct. and complete.
Signawre ol nsseswr
True Cash
Value
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(3) f-t�-�.. o
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Assessed
Valuation
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Homestead
Valuation
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- ACTION BY AUDITOR - ��
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Date: � 7