HomeMy WebLinkAboutHomestead_WraywRM Nc io ivrs
PrescriDeE By Sutt BaarE ol Ta. Commissioners
CLAIM FOR HOMESTEAD PHOPERTY TAX CREDIT FOR YEAR 192�
�� cwe� /Cv�-�. �, f-%�i'la.u,r- �- �.�.a.
d�Ch, 19 9 I, lWa� nr_.r.iiniwri as ni�r nrincirl nlar.e nf resirlanca
which a Homestead Property Tax Credit• is hereby being claimed:
I, (We) owned
❑ are buying under contract
❑ have a beneficial inter st in the tax a er
To & FiIW in Wplicak
4(9-0333(-00
✓
— certify that on the 1st day of
following described real property for
P Y
Property Description in -�� �unty �� Township
Taxing District (City, Town, Township):
Parcel Number
If buying 0(1 contract: Owners name ��� simoie owner�
or legal description shown on tax statement:
�,� �� %SC 7 a -/o , i6 a2.z.e4
Contract recorded in Recorders Office - Record No
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 oi the property utilized to produce income
Any other counties in which individual owns or is buying real property:
�hereby certify the above statement is true, correct and complete.
!� �
�lM.w� �� Nn� .0 S:. � . _
County
�
Township
K7c�o
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
Other Land
Total
Residential Improvements
JU�V 4 7 19�8a�
Other Improvements
T ' Improvements - Line (6�
I�by certify the above is true/
Signamre ot Assessor
True Cash
Value
(�) �
r�i -- O-�
c3� /90-0
Assessed
Valuation
�. •
Homestead
Valuation
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Approved: ��� ���.� t�G-C7 Date: le -,Z i- 2,9