HomeMy WebLinkAboutHomestead_Smithwarn xc io ism
PrescriEeE By Sute BaarE ol Tax Commissioners
To & FileO in WD���ate
CLAIM FOA HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19� J
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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 �—"a—r•^
Taxing District (City own Township):
Parcel Number
If buying Ofl contract: Owners name ��� simo�e owner)
certify that on the 1st day of
�ing described real propeRy for
Township
or legal description shown on tax statement:
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Contract recorded in Recorders Office - Record No. Page
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:
certify tF1'e) above st�tement is true, correct and complete.
County Township
�l %l0 7�
Ciry. Stare ana 2io �e
G'ndividual eith,�'r ownslor 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 ex4�ee.ding� 1( e) a�imj�etSiately
surrounding r�siden#ial i ov nts�—'
Other Land ,
�1;^,t ? 5 ;9?9
Total Land
Residential Impr eme s/���`k-�""" Dwelling
'� Garage
�� AUDITOR
Total
True Cash
Value
(t) �7-00
(2) �
(3) �O � o
(4) ��
(5) a-
(6) �
Assessed
Valuation
3-0 7 0
�-a '7 0
o ,�,o � 7
Other Improvements (�l
T ' Improvements - Line (6) plus p) equals (8) (8) � `� ��
I��oy certify the above is true. correct. and complete.
Signamre ot Asses
- ACTION BY AUDITOR -
Approved
Homestead
Valuation
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Date: � GJ 12s - 7�j