Homestead_WillhiteCLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOB YEAH IUX-?—
SE BACK FOR FILING INST UCTIONS Otte- o61aa o✓
I, (We) '�• .4ertify that on the 1st day of
Marsh 19�, I, ( ) occupied as our pri cipal place of residence the following described real property for
v a Homestead -roperty Tax Credit is hereby being claimed:
I, (We) owned
❑ are buying under con act
❑ have a beneficial mtetpt in /,the taxpayer
Properly Description in v
Taxing District (City, T n, Township):
Parcel Number.
If buying on contract: Owners name 1100 simple
Township
or.legal descri lion shown on la �Iaement:
&4 A I Ac 9.61 CAL '
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:
I hereby certify the above statement is true, correct and complete.
County
Township
Street Address
city. Stale and
Individual either owns or is buying under a contract that provides he is to pay rt
on the residence, or has a beneficial interest in the taxpaye
FOR ASSESSOR'S USE ONLY MAY 0 4 1989
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other Land
Total Land
Residential Improvements Dwelling
Garage -
Total
Other Improvements
Tot a rovemenls - Line (6) plus (7) equals (8)
1 h # certify the above is true, correct. and complete.
Signtnu a of Assessor
Approve
True Cash s ed %iZ�jHoomestead
Value ft au ITOR v �'ation
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
- ACTION BY AUDITOR -
ua,,
Date: