HomeMy WebLinkAboutHomestead_LamarWaAt HC f0 1979
PreuriGeG By Scate BoarG ol Ta. Commissioners
To & Filed in Dupiicate
CLAIM FOR HOMESTEAU PROPERTY TAX CHEDIT FOR YEAA 19 ��
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SEE BACK FOR FILING INSTRUCTIONS o�9_ o�s39 00
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�,;; (We) � � � � �'` � / � certify that on the 1st day of
�rch, 19 �° I, (We) occupie as our principal pl e of residence the following described real property for
iich a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract.
❑ have a beneficial i pt-e��res�t_ in the taxpayer
Property Description in �"�^"-Q--^y County ��� Township
Taxing District (Eity, Town, T ns ip): �/t<-.�-�-�-t-�
Parcel Number or legal description shown on tax statement:
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If buying on contract: Owners
Contraci 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:
I hereby certify the above statement is true, correct and complete
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County Township
Sta�e an0 Zip Coae
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.
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- FOR ASSESSOR'S'USE ONLY - ,
True Cash Assessed Homestead
Value Valuation Valuation
Land not exceeding 1(one) acre immediately
surrounding residenti�rov♦ements
Other Land T r ��
Total Land d�j`�
Residential Improvement�AR 25 j98�
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Other Improvements
Dwelling
Garage
Total
Total Improvements - Line (6) plus (7) equals (8)
I��.certify above is true. correct. and complete.
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Date: 3' c� S—� C� �
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