Homestead_Parke (2)t uilrl rw 11uk-_') iLrjj (( \U uu i I , l ('LUI I I UI\ IL/L
_SEE BACK FOR FILING INSTRUCTIOM
Pn.), other counties in which individual tens or is buying real pro party: County Itr:.ns1LiD
I I
r fy va
statorent i s ,true,
correc late.
Vaivatic:
/2Stre�et
tify that on the 1st day c I
Pz-Lrch, 19 I, (4)e) o- cimied as ur principal
ace of residence the .follawing described real �(
prorerty ro,. w 'ch a I1cup -stead Proparty Tax aecYit
is hereby
being clavred: j
II
uner a contract that provides he
is to pay the
0- 16"0,9Sl3✓
❑ are buyinq under contract
has a beneficial interest in the
taxpayer.
have a beneficial int est in the taxpayer
- FOR
FrocCrty D_scription'in
county
1b „ii :hi
Ti' dng District (City, Tome, lbw=ILip) :
//1
61&1
� y
pa-rcel HLMn r
or legal description S1.104i on tax statairst:
I
P+ SE'/U,
P4 c EC /j - "�I -30&
3 -a -9
I' bu ina on contract: Owners nay (fpe simle
o;•mer)
1
Contract recorded in Pnoorder's Office
- P--cord
1b. Pape
I` any por-don of the residential structure or
the land, not
e>reating one (1) acre that
i,in:_diately su_rrourrds that structure is used to
produce inane,
describe the use and portion of
tile oroparty utilized to produce irrmre
Pn.), other counties in which individual tens or is buying real pro party: County Itr:.ns1LiD
I I
r fy va
statorent i s ,true,
correc late.
Vaivatic:
/2Stre�et
/� // /! Z'
Prsiress City,
state wr zi
nature
*Individual eit)n_r
a..-ps or is buying
uner a contract that provides he
is to pay the
the residence, or
has a beneficial interest in the
taxpayer.
�on
- FOR
ASSESSOR S USE 01-ILY -
Nov 22 1989
Is�1
y ��une) acre ineredi.ately
si:rrroundinA irk ov ants
Otr:er iarO
Total Land
Pesidential Irprovurents Rve1 g
True Cash
Value
(1)
(2)
(3)
(4)
Garaae (5)
Total (G)
Ot)ier lmraJenents (7) —
7C ?rte ovenLnts - Line (G) plus (7) .equals (8) (8)
I eby.ce_tify the above is true, correct, and mrmlete.
x.cnature of Pssesscr
- ACTION BY UUDITnR -
Uate:
CCU -.i
Pzsessed
i
Fttncstep:i
valuation
Vaivatic:
/� // /! Z'
�• � ,•.
.:1
Late
W