HomeMy WebLinkAboutHomestead_SchroederPrim ec dy state ddmd of la+ Commns revs .
CLAIirl FOR HOMESTEAD PROPERTY TAX CREOIT FOR YEAR I9q
h _ SEE BACK/fOR FILING INSTRUCTION
4We) (l v —mil _ �N ✓w v w� -certify that on the 1st day of
9 I, (•`Ne) orpupfed as our principal place of residence the following described real property for
a Hom�est ad Property Tax Credit is hereby being claimed: q
I, (61e) o� �+ned 009
❑ are buying under contr a c O.
Cl have a beneficial inter n le_ t xpayer
Property Description in / Co ty Township
Taxing District (City, Town, Township): -
Parcel Number' or descr'ptio shown on tax sale t: tU
t, q If buying on contract: Owners name uee simple owual
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:
certify the above statement is true, correct and complete.
Individ
County Township
City. Smte and Zip Code
ther owns or is buying under a contract that provides he is to pay the properly taxes
FER0IF1'9Wence, or has a beneficial interest in the taxpayer.
FOR ASSESSOR'S USE ONLY -
AUDITOR
True Cash Assessed
Value Valuation
ind not exceedingj.1A(one) acre immediately
lrrounding residential improvements (1)
Cher Land (2)
atal Land (3)
esidential Improvements Dwelling (4)
Garage (5)
Total (6)
ther.Improvemenis (7)
ota'. i®ovements - Line (6) plus (7) equals (8) (8)
hereby certify the above is true, correct, and complete.
pidwe of Assessor
i[ili
m
Homestead
Valuation
AIN Mill