HomeMy WebLinkAboutHomestead_Gaston (10)WFM HC 10 1979
Prescri0e0 By S�ate BoarG oi ia. Commis5ioners
io & Filea in DuDlitate
CLAIM FOR HOMESTEAU PROPERTY TAX CREDIT FOR YEAR 19��. �
SEE BACK FOR FILING INSTRUCTIONS Org— O�-1 O$�P�
^ C�G ' .i . .y'. . �
�We) i�"'�'""""�`�o` � o ��--�-�-n-� �!-'-'-'���a-a-�"-' certify that on the 1st day of
arch, 19��, I, (We) occupied 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 interest in the taxpayer � Q �
Property Description in l� Cou �a�C�-�e-e-� Township
Taxing District (City, Town, Township): ��h-�'=-��✓
Parcel Number or legal description shown on tax statement:
(�.rQ..d� Q�� /.z q.b� -
If buying on contrect: Owners name �'� 51np1e Owne'�
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.
-� _ . � � _ n �,i �- � ., � �
noaress
U
and
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' 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
_;UN 1 9 197�ening
Garage
� ,� Tot
��1 T_ i
Other Improvements yj qUD170R
Tr•-' Improvements - Line (6) plus (7) equals (8)
I.by certify the above is true. corre� and complete.
51gnaWre ot nssessor
True Cash
Value
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(2) — d �
(3) � �'O—O
(4) �
cs�b$9°
(6) O
(�) O —
�s� ao
Assessed
Valuation
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�0 0"'D
Homestead
Valuation
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0
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Date: _/. -�C� �9