HomeMy WebLinkAboutHomestead_Walden (5)FOflM NC 10 1979
Rcuri�eG By State BoarE o� Ta. Cammissioners
Ta & FiIM in Duplicate
CLAIM FOR HOMESTEAO PROPERTY TAX CAEDIT FOA YEAR 19 7 9
SEE BACK FOR FILING INSTRUCTIONS
�(We) `�y a-C-�-e--`�
place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned �lV -� aoa a
❑ are buying under contract
❑ have a beneficial interest in the taxpayer �- L
Property Description in ,� ^ County �a-�-r-ie-"'-� Township
Taxing District (CiLy.Sswft-Township): �>"Q�
Parcel Number
If buying Ofl contract: Owners name ��re simo�e owneq
or legal description shown on tax statement:/
/ ( �,• / �
� �z .0 i. l �i.s �3 5� - i - i o �>
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.
/ "„� ��� i // Str.eetA00ress
IQ�XKLL LfifzLR4�tJ
County Township
Gry. State ana zip
' 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 residential improvements
T�otal Land � � � � �
Residential Improvements J�IV � `_' 19%g
True Cash
Value
(i) S'o 0
(2) / � / `f n
(3) � � ( � b
Dwelling (4� '3 9 i °
Garage
� ��, ���U�24� Total
Other improvements (/ AUDITOR
Tr' ' Improvements - Line (6) plus (7) equals (8)
I�oy certify the above is true. correct. and complete.
SigiuNre ol AssessOr
(5) —
(6) 3 9 / o
��� 39io
�8, 7azo
Assessed Homestead
Valuation Valuation
'� �����������
- �����������
G - i9- 79
Dare
Date: —_
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