HomeMy WebLinkAboutHomestead_McIntirewah+ Hc m iem
Preuri0e0 By State BoarO af Tax Commissioners
To & FileO in Wpliwte
CLAIM FOR HOMESTEAD PAOPEHTY TAX CREUIT FOR YEAR 19�� /
SEE BACK �'Fll�' STRUCTIONS Ql� _�/C�73. 00
i
,SWe) ��-' � - �,'�{�(� certify that on the 1st day of
n�arch, 19 I, (We) occupied as our principal plac f 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
Property Description in �-� /-�-�+� County ��� Township
Taxing District (City, Town-�vwrtsfiip): � � �
Parcel Number or legal description shown on tax statement:
����. � sr � Pl.
If buying on contract: Owners name ��� simD�e
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:
' 4ereby certify the above statement is true, correct and cor�il'ete.
� .�
���
Sveet noaress
County
Ciry.
Township
ana zio 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.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residential improvements
Other Lan1
Total Land � � g � �\
True Cash Assessed Homestead
Value Valuation Valuation
(1) �� �J o .5 O
(2) —
(3) �d �/ o
0
� SD
�j�j��jjj
j/�jj�j�/j
. . . . .. . .. . .. . .. . .. .. . .. . . . . .
��������j�
/O%%�i
a� ,,,�,�
r� >
��������
�����������
� -�y �
Dare
Date: G--z7-7y