Homestead_Dougan (3)\.0 1111,1 VIN 1.' -1 LV IJ "J II IV: Ll \11 �` +. •� "" `-' ." O
SI E BACK FO FILING INSTRUCTIONS .
1 ..1,;_) l A certify that on file 1st day c
1•_sci?, 196)0, 1, (Sie) cccuP,ed as ou_r princioal ace of residence the.follaaing described real
i� q nrty o- l r c. a I1or>_stead Property Tax Credit is hereby being cla -bred:
I'..�) 1 'vTt 00 9-91
DL'•; 1-'?R u.fda -r contract
(� have a h— an interest
'ilGL'°_rty �Jj? e ta�oaver
D°scrlptio n. 1,11
County '1•Uia IGIII
_,tea- �.S r1CL ( l y, _a.i :b \Y 511 D) • �\ I
Parcel ilullber. . I or legal description rnm on tar, statomllt:
CVO � 5
1_ buvip.ci On cont=act: Q.,.n =s Viii° (fee sijrole orvinar)
Contract records -i in p °Corde -Is Office - PMard HD. Page_
1= a;;v portion of the residantial str'uct=e or the land, not ,re-aiing one (1) ace that
l;iii=!\at °_lv :s'L'r"rou;Tls that structure_ is used to produce 1nCalle, deSCr11.�°_ the Use afIl L'Ort1011 Oi
Lh°_ DroCerty utilized to olcmduce L'rOire
]ny O�-;°r CJti ?ties l_;? 4i[i -ich indi'vid't al G`.\-ns Or is buying real property: County
'itr•.nsllip
1 eve stateirent is true, Correct and ccm--plete.
U v`
,��° Street iY.'�res5
city, State atri Zip CLU ".
*individual elt.1 -rer a.,n•s or 1s b.lying liner a contract t kit provides i-° 1. '�
eMMI
Dr0 ^ —t- 't -axes On t11 °_ reSld°11ce, Or has a b°._IleflCi al lilte.LeSt in
le
FOR ASSESSORS USE ONLY -
1r11'LI r
1 (One) acre iii'iie(1lately
S rrour> ing residential inQrov--;ents
other Land
`1'o t-:l Land
pesic!onitial LlGfov'eYen.s
;•selling
Garage
Total
True Cash
Valle
(1)
(Z)
(3)
(4)
(5)
(G)
oth°- 1rmrcvonen-Es (�) —
'?c ;in- ove-,jans - one (G) Pius (7).equals (E3) (II)
e':,y C°' -`i-11 }' lil°_ abzr re 1s ;i1Z'.e, correct, a1'ia GC7ilplet°_.
J1�i ?a tl:Y °_ O: PSSessCr
- ACTIOII BY GIUDITnR -
JAN 00 1990
/J I�sessed lbl- ester ::
cc ag`t&n uati
�iYOR
to
^ �. t Date; ) -�0
xx r �
// / /Mm
to
^ �. t Date; ) -�0