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HomeMy WebLinkAboutHomestead_WirthCLAIM FOR WSrW PROPERTY TAX MIT FOR YEAR 19—!L0 / S-E BACK FOR FILING INSMcrlONS bA *. 0a'd - dO certify that on the st day c a t followic? dscr =bed real ruLlce of res=ence jplr^h, 2.9 I, 47e} oc- : -1eml Prvte�Y for which a ta�a_�• -tead ?moeztY Tax credit is hereby t,a;.g � = are buyin.? :naer contract M have a benefice al int_r"t i rt t1-- tax�Daya. r . G , boo nJ County Towrstti ring n: c=ict (City, To,. Township): P� ^°1 21tsb°S _ or legal ds`ig` -ion srxy,-: on tax sat�--zt: ,Cots T, ,y on cmmt:ra_• Ooze's rate (fee Page C=rraC v recorded in R_OS"Qar's Q=S1ce - Pad No. - a n e or the land, P� =`-" -e or- (1) a.Sa- that L arty rcrr; ter+ of the residential structure i�m, ds�be t1= use and port of ately stnsptads tttat stn --ture is used to nroact� the Drury Ur- lazed to -%)Cn ce iarnme pny o='r_r toughies in which individual va>_s or is buying real property: �I hereby certify the above statma't is true, correct and cozr�tlete. County - 1174.'^S11p Jy \� navare Provides he is to pay the *Individual either tams es de ce, or razes a contract that prvices ty taxes on tip - a =;,;anc�, or has a beneficial inters -s't itt.the gayer. - FOR ASSESSOR'S USE OPLY - Tama not aa;;ng 1 (on-) a—•-re :.._,°a;ate Y .. sLlZtttd=9 Zoci pan ial ]S.JrOV�t Qtl °_r Land Total Land P_sidanti --' Im=oVeents Dca'lirt4 Garage Total True Cash - Valza (1) O O (2) (3) (4) (5) (6) 00 O (7) To ^ mveinetzts -Line (6) plums (7) em-- Llsa}(8) (a)) I c=-tr.ry . Assessed Valn3 icn 3oa (p d U y';77 a� DdL° - ACTION BY .a.UDITnR , Date: Fmesteaz Valuatiot 3