HomeMy WebLinkAboutHomestead_Montgomery (5)POPM HL 10 1979
Pfescri�etl By State Bw�O af Ta. Commissianers
To Be FileG in Duplicale
CLAIM FOR HOMESTEAO PROPERTY TAX CREDIT FOR YEAR 19�L `�
SEE BACK FOR FILING INSTRUCTIONS p/q_ o�$6q�0O
n •
�'(We) `� ���-�-�-+L, - certify that on the 1st day of
vlarch, 19�, I, (We) occupied our principal pla e of resi ence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) C'3�owned
O are buying under contract �
❑ have a beneficial int,e�r/es�t �in the taxpayer �/�
Property Description in .a!l.c_,G-d..e�w County �7''� Township
Taxing District (City, Town, Township): �/�-��� ����5
Parcel Number or legal description shown on tax statement:
� . _ � . _
If buying on contract: Owners name
Contract recorded in Recorders Office - Record No
.O�
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 certity the above statement is true, correct and complete.
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County Township
u�y. a�a�e ana up woe
' 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) acr��diat� � �
surrounding residential improve ents
Other Land
Total Land
Residential Improvements
,��': ;� i979_
' � �r:
/ . /-
� �.! �•
Other Improvements
T Improvements - Line (6) plus (7) equals (8)
I�eby certify the above.is true. correct. and complete.
ot P552550r
A
True Cash
Value
(�) .;2700
(2) �
(3) �700
(4)
(5)
(6)
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fE)1—
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
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Date: _�/ ,�