HomeMy WebLinkAboutHomestead_ZillerFOftM HC 10 19i9
NeuribeC By 9a;e Boa�O oi ia. Commissfoners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19��
io Be Filea in Ouplicate
✓
SEE BACK FOR FILING INSTRUCTIONS O/g� �33 g/.DO
;��'' ,��,-�.�.�.. �L. , %� " A--, �,�.e.�.� �
e) certify that on the 1st day of
�tarch, 19 7, I, (We) occupied as our principal pl of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) C� owned
❑ are buying under contract
❑ have a beneficial interesj in the taxpayer
Property Description
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name �'� �""o1e °`"ef�
�� Township
or le9al description shown on tax statement:
�o-z,c�cn..� `�-%�'� 8 �
Contract recorded in Recorders Oifice - Record
If any portion of the residential structure or the land, not exceeding one (t) 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
ti���by certify the above statement is true, correct and complete.
� �U �, ,
O �gnaNr� � �� A�ess � �� ' CitY.l+tate ana Zip Cotic.
�/�Cr� L��!
' Individual eithe wns 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 -
� � � � � True Cash
Value
Lantl not exceeding 1(one) acre immediately��N u 6 1979_
surrounding residenlial improvements ��) �/��
Other Land n ��///'/��k��/�') — � —
Total Land t��, J"r � r"1s1 a/�'D
�T AUDITOf�
Residential Improvements �� Dwelling `4� �
Garage �5���� /�'���/p �°__
Total �6� ��
Other improvements
To��� .I qrovements - Line (6) plus (7) equals (8)
I: .�V-orcertify ihe above is true. q�rrect. and corr}plete.
XI �'�-�'— tD �c
Signamre ol nssezm�
(�) � O
(g� O O
�� �
IfIITlIR _
Assessed
Valuation
73 0
—o —
��
.�,
� �a
Homestead
Valuation
�ic(�7
� �������
`%i
i�i%���
� - aa- � �
oaie
� 11 1 '1 ��'�_L �. ' / � /