HomeMy WebLinkAboutHomestead_McKee (4),
�. WRM HL 10 1979 T-
PrewiOeG By Sam Bwm of iaa Cammissioners
io Be FileG in DuO���ale
CLAIM FOR HOMESTEAU PROPERTY TAX CREDIT FOR YEAR 19�� �
SEE BACK FOR FILING INSTRUCTIONS O�Q � D�QQ a�' ��
�;�ich a Homestead Property Tax Credit is hereby I
I, (We) �ned
❑ are buying under contract
� have a beneficial interest in the taxpayer
Property Description in ,.�l.cA.�.o�
Taxing District (City, �e�v�ip):�
Parcel Number
If buying on contract: Owners name �'� "'"o1e °""ef�
�/�_�-�j �� certify that on the 1st day of
of residence the following described real property for
a claimed:
nty �p�.�.,
� Township
or legal description shown on tax statement:
�2.�.,� .�-�- ,��.�-- � i
,
Contract recorded in Recorders Office - Record
i
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
I hereby certify the above statement is true, correct and complete.
5treet naaress
a
Gty. State ana Zip Q^J,> '
t���
Individual either owns or is buying under a contract that provides he is to pay the properiy taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrountling residential improvements
Other Land FILED
Total Land
Residential Improvements Dwelling
MAR �= 1980Garage
i
Other Improvements �� A�p�pR
Total Improvements - Line (6) pl�s (7) equals (8)
I;�)y certify�the above is true. correct. and complete
ol
True Cash
Value
(�) .3(0/0
Assessed
Valuation
��o 0
. � ..
, i . � '''!����������
��/��jj
, ,
. .
- ACTION BY AUDITOR -
Homestead
Valuation
� ..3 - 'il d�o
Daie
Approved: Date: