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CTRECORDED
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
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County
Township
Taxing district (city, town, township)
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Legal sc lion ///I�_ /^' /
Is the property in Question:
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❑ Real property ❑ Mobile Homo (LC. 6-1.1 -7)
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.
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WMIM
T' ASSESSOR�USE ONLYA" r
a -TRUE TAX' 'ti
County Township
County
Township
hereby certify the above statements are true, correct and complet
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an
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Land not exceeding 1 (one) acre immediately
WMIM
T' ASSESSOR�USE ONLYA" r
a -TRUE TAX' 'ti
ASSESSED VALUE
,'=f,"HOMESTEAD n'
" NON= RESIDENTIALq
Valuation or 535.000
$
Signature of Auditor
Date signed
" y'VALUEi -k— a
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
�i'~,
Residential Improvements or Annually
Assessed Mobile / Manufachued Horro
Garage
()
Other improvements
(6)
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F,
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
hereby certify the above is true, coned, and
Signature of Assessor
Date signed
complete.
Venfybg action - Signature of Auditor
Date signed
w�a _.s.. u '�"r`"- °•'c'- fir.. -
AL
��,.-_STANDARD�DEDUCTIO N
� LOWANCE
20 Pay 20
Lesser of 111 Homestead
Valuation or 535.000
$
Signature of Auditor
Date signed