HomeMy WebLinkAboutHomestead_McClellan (2)FOPM NC 10 i979
neu��eee By State BwrE ol ia. Cammissioners
ta Be Filed in Duolicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19� ✓
SEE BACK FOR FILING INSTRUCTIONS O/Q�D/py/�_mO
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�(We) /�%��ooPnY � Ecin� /'Il. �77r_ �',�Gl�ctrl 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 r� _
Property Description. in Cri/�Sarl County 'ra-inkc�- Township
Taxing District (City, Town, Township): �r�/1L�Fc�n 1—Jf)✓1 rX �6
Parcel Number �� or legal_ description shown on tax statement:
�� k.�. .�<.,_ b D 7 �. d 3- �L
If buying on conlract: Owners
Contract recorded in Recorders Office - Record No
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
� y certify th e ateme is true, correct and complete. ,
e �
'Signamre Sue¢� Aaaress Ciry. Sta:e ano Zip .�ae �� /�O
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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
ootal Land � � � � �
Residential Improvements Ss79
�1�� 9 Dwelling
(/L . `/�i /�(^�-��:�(1i(i
Other improvements �% AUDITOR
.
Garage
Total
True Cash
Value
(1) /�%�
(�) —
(3) i47o
(a)
(5)
(6)
(�)
Tr��� Improvements - Line (6) plus (7) equals (8) (8)
f�by certify the above is true. correct. and complete.
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Sig � e ol Pssessor �_
- ACTION BY AUDITOR -
Assessed
Valuation
(O :ic
(pZJ
Homesiead
Valuation
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.
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Da:e
Date: