HomeMy WebLinkAboutHomestead_SchmidtFOPM HC 10 1979
PrewiGeG By S�ate BwrG ot Ta. Lammissioners
io Be Fllcd ln DuO���ate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 � 9 �
SEE BACK FOR FILING INSTRUCTIONS Q�9 - o a yq y' ��
�(We) ���-� `>'-�-�r� �- ���« �-� certify that on the 1st day of
arch, 192`� , 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
Property Description in �L/�-1-�---•� County ��-��- Township
Taxing District (City, � Township): 0/�-���
Parcel Number or legal description shown on tax statement: .
GQ-2-�� ��.c,� 7G �.
If buying on contiact: Owners name �'� simo�e owner�
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 poriion of the property utilized to produce income
Any other counties in which individual owns or is buying real property: County Township
�L
statement is true, correct and complete.
' 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 immetliately
surrounding residential improvements
Other Land
Total Land
Residential Improvements
� �
� �Dwe�9
. "rcr Garage
� 2 `' �9i9 Total
True Cash
Value
(�) �(030
(2) —
(3) / �30
(4)
(5) �
�s>
Other Improvemenis � � f� // (�)
//'
Tr Improvements - Line ,(6) plus (7)•�equals 8)� (8)
I�by certify the above is true. corre�t��r d�complete.
� � _ .«- dR "
s�yw:u,e a� nsseswr
3/0
Fo
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- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
05'S�o 05'�/0
(-zi-7
oa:e
Date: _��=�- 7�