HomeMy WebLinkAboutHomestead_Thompson (11)fOfIM HC lU 1979 �
RewriOeG By Srote BoarE oi Tax tommissioners
Ta & FileO in WD����e
CLAIM FOR HOMESTEAD PROPERTY TAX CHEDIT f0A YEAR 19�� ✓
SEE BACK FOR FILING INSTRUCTIONS �/G,— O�%Oq.pQ
� 7,c��, o� �
'�SWe) � �rtify that on the 1st day of
��arch, 19 9 I, fWg1 nr_.r.�inied ag pi�r nrinr.ioal„�lar_.a nf residenr_.g t�a fpllnwing dOSCribed real propeRy for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) �owned ' .
�$ are buying under contract
❑ have a beneficial inte est in the taxpayer
� 1
Property Description in ^�✓ Cou �' Township
Taxing District (City, Town, Township): �-r p—��—�^,
Parcel Number
If buying on contract: Owners name �'tt "`"o'e
Contract recorded in
or legal description shown on tax statement: .
D-,c�-C-��^,._, 9 s� .
�_ . � . ,n
- 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: County Township
�hereby certify the above statement is true, correct and complete.
%( � n .�.�: �-i?.�,o,��1 3 j.f�a-2.u.�` (�iLe�-«-�-c,�-� �,,,, ��a S/�%
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naaress
Stare and 2io �e
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
T�otal Land � � � � �
Residential Improvements Dwelling
JU! 2 i979
Garage
Q�����u� Total
Other Improvemenls � AUDITOR
To"' Improvements - Line (6) plus p) equals (8)
I�oy certify the above is �e. correct. and �omplete.
Sigre:ure oi Asseswr
Approved
True Cash
� • Value
(1) �O O
(2)
(3) O O
Assessed
Valuation
� 8v
— o— —0—
(a)
(5)
(6)
(�)
(8)
Homestead
Valuation
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Date: