HomeMy WebLinkAboutHomestead_GordonFOftM HC 10 19ID
PrescriOeC By Slnre Boa�G ol ia. Cammissianers
To Be FiIM in Ouplica�e
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT fOR YEAR 19�� ,/
o - SEE BACK FOR FILING INSTRUCTIONS QlC,� QOq�O • Oa
�(We) -Q-�-a� /d -��-��—� • � certify that on the 1st day of
March, 19_��, I, ( e) occupied as our prin paf 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 int�rest in the taxpayer
1:/ . ,
Property Description i
Taxing District (City, Town, Township):
Parcel Number
ry �� Township
, .—
or legal description shown on tax statement:
�-� .�,�.c— oC1—�--, .�_�
If buying Ofl contract: Owners name ��� z�mo�e owneq
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
e
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 ac� im �iate� �
surrounding residential i ve ents
Other Land
Total Land
,;uN 2 21°?9
Residential Improvements Dwelling
�%� �%/ arage
r�� '�}', Total
(� AUDITOR
Other Improvements
T�Improvements - Line (6) plus (7) equals (8)
I �reby certify the above is irue. coyf�ct. and complete
Signamre ol Assessor
- ACTION BY
True Cash
Value
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(3) T�
(4) ��CT
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(6) ���
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($) ��
Assessed
Valuation
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