HomeMy WebLinkAboutHomestead_WickPrtsn�Eea By Aale dmm ol laa (qmmisvoners
CLAIM FOR HOMESTEAU PROPERTY TAX CREUIT FOR YEAR 19 �% �
SEE BACK FOR FILING INSTRUCIIONS ��9_p3a��-oo
.. 7�% 9 41 ..O � , a
�, � �� °' — ccrtily thal on �he 15� day ol
Ma� 19_, I, (We) ccu d as our principal plac of residence the followiny described rea� property (or
which a Homestead Property Tax Credit is hereby being claimed: �_
�\� .�
I, (We) � owned
❑ are buying under contract
❑ have a beneficial inte i the taxpayer
Property Description in County
Taxing Dislrict (City, Town, Township):
Parcel Number' or leg
If buying on contract: Owners
Township
riplion shown on lax statement
Contract recorded in Recorders Office - Record No. Page
Ii any portio� of the residential struclure or the land, nol exceeding one (1) acre that immedialely surrounds that
siructure is„ used to produce income, describe the use and portion o( the progerty utilized to produce income
Any other counties in which individual owns or is buying real property:
certity the above statement is irue, correct and complete.
�
County
Township
�_��7� ��
Cnr. Si.,ic a„�i z�n coa�
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Individual either owns or is buying under a conlract that provides he is to pay the propeity taxes
��' on'��the`residence, or has a bene(icial interest in tlie taxpayer.
I��Y 31 ?��3
LUrt/)Ll� � %�°�S
- AU�IiOR
- FOR •ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
>urrounding residential improvements
�ther Land
Total Land
Resideniial Improvements Develling
Garage
Total
True Cash
Value
l�l
(zl
(3)
��, _
I5� ---
�6�
Other rovements ��� ----
Total�rovements - Line (6) pius (7) equals (8) lel _______—
I hereby certily the above is true. correct, and complete.
Sipnatuee ol Assesso�
- ACTION BY EIUDITOR -
nssessed
Valualion
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Homestead
valuation
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