HomeMy WebLinkAboutHomestead_DriskellFOPM HC 70 1979
RescriEW By SUte BwrG of Ta. Commiuioners
CLAIM FOH HOMESTEAD PROPERTY TAX CREDIT FOA YEAR 19�L
To & FiIM in DuD�icate
c./
0 �Q — 00'�I � � - �O
�(We) �''�� certify that on the tst day of
arch, 19 `(We) o upied 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 '
❑ are buying under contract
❑ have a beneficial intere in the taxpayer
Property Description in '�� County � Township
Taxing District (City, Town, Township):
Parcel Number or legal description shown on tax statement: .
�X' �1 � �}� %-d7-/a � 33��.
If buying Ofl contract: Owners name ��"� s�moie owne.l
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
' 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 1(one) acre immediately
surrounding residential improvements
Other Land
Total Land � � � � �
Residential Improvements Dwelling
� JU.I � 0 1979 Garage
Other Improvements �
T ' Improvements - Lind
I �by certify the abov�'
Siqnawre ol Assessor
� �.
.�
P��s ��) �Q�T��)
true. correct. ay�i complete.
Approved: � /�6�g-���
True Cash
Value
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(2) '—G—
(3) o?v'2!a
(4) �d'
(5) l%-�P f �
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(7) '-0--
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Assessed
Valuation
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Homestead
Valuation
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Date: �7-30-�9