Homestead_HarringtonCIAI[i FOR HOI-STEAD PROPERTY TAX CREDIT FOR YEAR i9f .
S BACK FOR FILING INSTRUCTION$ 016- 00S3V o�
.' that on the lst day c
described real
A +arrh, 29 , Z, (� ) occlmiea3 as our princi. ulace of 4FV co tl>° following
nrop�rty ror which a Flan °sty Prop -rty Tax wit is hereby being claimed:
are buying under contract
have a ben=.yir'; al interest in the taxpayer
Property Description. in /�c� � County t'
ct Town Towr>_ship)
Taxing Ui ,
P=--1 or legal description shown on tax staten-ent:
A, -- as
If bq,ing on contract: Owners ia1+a (fee siimle owner)
CmTtract recorded in P-ecord°_r's Office - Ieccrd No. Page
If any portion of the residential structure or the land, n�exceeding ; describe �1) a aetmrtion of
imneiiat -ly surrounds that structure is used to prodace
the property utilized to Produce il=am
counties in which individual owns or is buying real property: .
County TOWnS11D
Any other
I hereby certify the above statmmtpis
true, correct and complete.
/ X77` 0
g't Address
City, Sthte and Zip Code
Sl
owns or is
buying un r a contract that p>�s he is to pay the
•Isldividual either
cr has a beneficial interest in the taxpayer.
property taxes on the *Q =;�°*�,
- FOR ASSESSORS USE ONLY
True Cash
Assessed Bm steac
Va11L
Valuation Valuatoa
land not exoeeding 1 (one) acre ar�at
�
=1Y (1)
', cio
surmun3ing 14-. ,a1 �� varen
/
170 E ���/�//
g ��
Ot1Y� Land P.1
(2)
/
Total land NtFtR 1 '1988
(3) —_
Im=0venmts
Dwmll;nn (4) Grage (5)
MIpaiaential
AUDITOR
(6)
�/7Sn
Total
Other Ilrprwer>°nts
To • 7imzDVements - Line (6) plus
(7) equals (B) (B) —
`�� fy the above is true,
come , and analet°.
I � rti
Darr
signature of Assessor
ACTION BY AUDITnR -
Date:
//