Homestead_GriffithI
A uuU!i ivi. iuu -L-JW � l %
IhlS RUCTIONS '
'I
certify that on the 1st dal c
ce of residence the .following described real
is. hereby being claibiixi:
armed, "
are;btryinq under contract '
have a beneficial int e l ' ? he taxpayer
ro:: -arty LLscription in County 1'v. ;ii ^Iii
1
wi: ^.g D'_strlct (City, To.-m, !b'emslllP)
a-rc.a' ;7u I or es�iption si Vii on tax sta met I
buvi —o on czmtract: O.,mars mile (fee sirrrole u, -mar)
Con ract recorcied.in P_corder's Office - Pecord Ib. Page
a;n+ co=lon of the residential structure or tide land, not e>�exling one (1) acre that
Rrl:-=diat°_ly surroui s that structure is used to produce inane, de5CL11Y_ tll °_ use aid pOrt1011 of
1 ?e p odty u�; I i 7ed to prcduce income
�: ii' Otner CJL ?ties i-n wh—iclh indivld'r al O`-ms or is buying real propa._rty:
ire cartiry the aLov2 s atorent is tru�e /, oorre: tgard coiiplete.
7 'ii Y/, _ l� D /�l D , A
County 'lYr:.nsiuo
I,Zdx _ � 7664
❑nat e Street tddress 'tj, State aid Zip Cfcu-.:
*Indiviclttal eiUn_r a +ms or is )-eying caner a contract th t provides he is to pay t)le
0 ope ty axes on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR IS USE ONLY -
-ar,d not evc°erLI!-ng 1 (one) acre .imrediately
;L•r -ow, -ding residential iroprove-ients
)tare Land
I'o-..al Land
P --sidential Irprovarents D �1Linq
Garage
Total
Other Imp ova ents
(1)
(2)
(3)
(4)
(5)
(6)
(7)
True Cash
Value
'10 -Line
(6)
plus
(7).eauals
(D)
(D)
�JCprovenants
I r_, �y
c° -t± the
i.f
above
is
true,
co rect,
and
cza nlete.
Si- nature o: Assessor
IUsessed Flaleste<,_
Valuation Valuati
r
MIN <.)
s
t
Lt� to s
i
- A TIOII BY AUDITnR -
p Uate: /