HomeMy WebLinkAboutHomestead_Curl (3)CLAIM FOR HOIESTEAD PROPERTY TAX CREDIT FOR YEAR 19_2F v.4
If bu_vina on contract: Owners name (fee simole owner)
Contract recorded in Recorder's Office — Record No. Page
If any portion of the residential structure or the land, not ex--eedi.ng one (1) acre that
immediately surrounds that structure is used to produce incase, describe the use and portion of
the property utilized to produce income
Fny other counties in which individual awns or is buying real property: County TcwnshiD
reby certify the above statement is true, correct and complete.
*Signature Street Address City, State and Zip Code
*Individual either owns or is buying uuner a contract that provides he is to pay the
property taxes on the.residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSORS
USE ONLY -
�
SEE BACK
FOR FILING INSTRUCTIONS
Oo�'
Assessed Homestead
certify that on the 1st day of
19 I, WeY occupied as our princiDal place of residence the
following described real
r. rty for which a Homestead Property
Tax Credit is hereby being claimed:
I, a-;e)
downed
6� /�,_/-;;7-
X/._
are buying under contract
Other Land
have a beneficial interest in the taxpayer
Property Description in . -�
County
Township
Taxing
District (City, Toom, Township):
170
P.esidential Innrovements
Parcel
Nunber
or legal de scr ption
on tax statement:
Garage
S� S L /7-.Z-
/zz-
If bu_vina on contract: Owners name (fee simole owner)
Contract recorded in Recorder's Office — Record No. Page
If any portion of the residential structure or the land, not ex--eedi.ng one (1) acre that
immediately surrounds that structure is used to produce incase, describe the use and portion of
the property utilized to produce income
Fny other counties in which individual awns or is buying real property: County TcwnshiD
reby certify the above statement is true, correct and complete.
*Signature Street Address City, State and Zip Code
*Individual either owns or is buying uuner a contract that provides he is to pay the
property taxes on the.residence, or has a beneficial interest in the taxpayer.
Date
- ACTION BY AUDITOR -
aDaroved: Date:
- FOR ASSESSORS
USE ONLY -
True Cash
Assessed Homestead
Value
Valuation .Valuation
Land not exceeding 1 (one) acre immediately
improvements
(1)
7 D
surrounding residential
un
Other Land
(2)
Total Land
(3)
Jr / O
170
P.esidential Innrovements
Dwelling
(4)
Garage
(5)
Total
(6)
qq
Other ImorovaT eats
(7)
/�
To- Imorovements - Line
(6) plus (7) equals (8)
(8)
4A 6, % �
.I hereby certify the above
is true, correct, and
o mrlete.
s
_
Date
- ACTION BY AUDITOR -
aDaroved: Date: