HomeMy WebLinkAboutHomestead_Williams (34)WflM MC 10 7979 �
Presai0e0 By 51ate Baard ol ia. Commissioners
CLAIM FOR HOMESTEAU PROPERTY TAX CREDIT FOR YEAR 19 � 9
io Be Filea in Duplica�e
�
� SEE BACK FOR FILING INSTRUCTIONS o/�� O3 ,���' � O
(We)�� 7 �R � /(% ',/ � o � �
-�-�/ /�. • `-�"_-�'-� �' w'�'�'�`-Q-'�"�°' certify that on the 1st day of
�arch, 19?�, 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
O are buying under contract
❑ have a beneficial inte si� taxpayer
Property Description in County
Taxing District (City, Town, Township):
�
Township
Parcel Number or le I description shown on tax statement:
,� Q�C.G a �
If buying on contract: Owners name �'� ��mo1e owneq
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 portion of the property utilized to produce income
Any other counties in which individual owns or is buying real Property:
hereby certify the abbve statement is true, correct and complete.
�.�� � �t/L�-�-Q�tA-
� �.�. »?. _�, ?�:2e�..-,..,�. 7�yS /� .� �iu
Streec naoress
County Township
/� �767°
Ciry. S�aie ana Zip Cpoe
Individuaf 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 ihe taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1( n� acre im�nediai� �
surrounding residential improv�ements�
Other Land
Total Land ,';;F�? � � i=7� ,
Residential Improvements Dwelling
l/i ,��'l�atk�2�arage
RUDITOR Total
Olher Improvements
T� Improvements
Line (6) plus (7) equals (8) :
>�e,is true. correct. and complete.
True Cash
Value
(1 ) /OSo
(2) —
�3� /o,so
�� - ACTION BY AUDITOR -
Assessed
Valuation
�So
3So
0
Homestead
Valuation
3Sa
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Date: l ' z 7 `� �t