Homestead_MerrimanCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR '192Y-
BACK FOR FILING INSTRUCTIONS
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I, (We)
f I certify that on the 1st day of
A 1 W I, (We) occupied as our principal place of residence the following described real property for
w Homes Property Tax Credit is hereby being claimed:
I, (We) owned
Cl are buying under contract
❑ have a beneficial interlqjian the taxpayer;
Property Description in �i Co my Township
/r
Taxing District (City, Town, Township):
Parcel Number, or legal. description chow on to talement:
If buying on contract: Owners name Ilee simple oxnerl
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: County Township
I hereby certify the above statement is true, correct and complete.
766
. ,. Street nearess GnY. Stale an ip Goae
Individual eithBT=a ffiresWr nder a contract that provides he is to pay the property taxes
has a beneficial interest in the taxpayer.
FOR ASSESSOR'S USE ONLY -
MAY o 2 1989
Homestead
Valuation
S
Land not exceeding 1 (one) acrAWITRAY
surrounding residential improvements
Other Land
Total Land
Residential ,Improvements Dwelling
Garage
Total
(1)
(2)
(3)
(4)
(5)
(6)
Other Improvements (7)
Tot mprovements - Line (6) plus (7) equals (8) (8)
1l )y certify the above is true, correct. and complete.
5lgriawre of 0.ssessor
True Cash
Value
Assessed
Valuation
nn ••
Date: —!5 — 9