HomeMy WebLinkAboutHomestead_Williams (35)FOflM MC 10 1979 -
Reuri6ed By State BoarO af Tas Commiuioners
CLAIM FOR HOMESTEAD PROPE�TYo�i( CREDIT FOR YEAR 19Z�
c1(�� .� \
Ta & FiIM in Du0licate
c�
alq - 03 as� -�
�(We) � J�—a—,-,,,� ) ,�IAl1�J �f �,C� �certify that on the 1st day of
arch, 19�2, I, (We) occupied a 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
❑ have a bei
Property Description
under contract
�frial,;mteresf in the taxpayer
��-� Township
Taxing District (City, Ter+rt;-Faern9#�iga= �J�� --�-� a= � �`-'
Parcel Number or le al description shown on tax statement:
� � .�G �/ %� a� — / U . J �lit�i�-�
If buying on contract: Owners name ��� simo�e owner)
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: County Township
� hereby certify the above statement is true, correct and complete.
,�� � ��! "� ��.,.� �j:� ���5�- }��:m � , IN �7(o I
'Signatwe � Sueet Aa ress G. tate ana Lo �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 (� ��m��
surrounding residential i o m ts
flthor I �nri
Residential Improvements
�
Other Improvements
JUN ? � i979
True Cash Assessed Homestead
Value Valuation Valuation
( � ) � a--D
cs, �a—a—�
Dwelling `"'
/�`11�=c1�LRi(J^ a� e �^^-'°d'-( 5 )
AUDITOR T_,_, �g�
Line (6) plus (7) equals (8)
�ove is_true. correct. and complete.
� �—d
�—a a-79
Da;e
�