HomeMy WebLinkAboutHomestead_Youngsonwua nc io i9rs
Rescribe0 By S�ate BoarO ol Taa Commi55ioners
To & Filed in Mpliwte
CLAIM FOH HOMESTEAU PNOPERTY TAX CREUIT FOR YEAR 19�� /
SEE BACK FOR FILING INSTRUCTIONS O�g-Q33�$`��
�(we) �J . � �
arch, 19 I, (We) occupied as our principal place o esid n�
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under .contract
❑ have a beneficial inter t in the taxpayer
Property Description in ,
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name «� 5im01e owner�
�ertify that on the 1st day of
ing described real property for
��0�'��% Township
or legal description shown on tax statement:
/ /1 d-v✓c..o-¢_. !� �,�
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:
�hereby certify the above statement is true, correct and complete.
i . . . A n �. . i _ // //L� — �
ACCress
r
County
Township
CitY. State ana Zio �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
�UN 4 7 1979 Dwelling
Garage
� /��2`� Totai .
Other Improvements" ` �/ ��
T ' Improvements - Li(fe (6) plus p�I�U�B (8)
I�by certify the above is true. correct. �d complete.
a�2.. �
Si9�mre ol nssesmr
�
True Cash Assessed Homestead
Value Valuation Valuation
(�) //�o
(2) — ° —
(s) l /�o
(4)
(5)
(6)
(�)
(8)
- ACTION BY AUDITOR -
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Da:e
Date: �� 4