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HomeMy WebLinkAboutHomestead_Dowty. l,Ui1Pl fUi� IlU'L�IChU f"I\Uf Cll� i irv� �i�t i i ui� iuu� l.i�� ! / i ` S[E B;�,CV FOR FILIPJG Ih�STRUCTIOh;S .- �( � I,'•., eN)- (`l'�,,,�� �. �:�,-�- \ certify that on tt�e lst daY �' I F�irch, 19 , I, (i•le eccu�i�r3 as our princioal olace of esiden� tt�e .follv�uinq descriJrd real � nrv,r.�rty ior �•;'r.ich a I!otr�st�s3 °ro�sty Tax Credit is herel�y b�..inq claumcl: .. � poS�O� y.7S. /.5'G 9� . ( I��are bu�inR un3er mntract�Gt�Co-�/�O�7a�'GYX)•.`��%=D�/ QQ�•.bp�75 � have a}y.�eficial interes` in the `�.�ayer . �:rp�•�rty D�scrip�io�i. in ,Q,Q,(L> �unty 7b�:ii:tii � 1'a>�.�r.g District (City, Ta:n, 7bcansttip) : � � i�escel I'.�un1r_r I or legal clescripL-ion s}iorm on tax st-atamst: �-� � `la � � �/� -1 (o I I= fJL";?'l7 O.Tl CJl1'rd�: �.va _S IY37SL-^ �'2°_ SliTSJ1E CIvRI�) � Co::u.act r�ord� in P°e�rder's O�fice - P�cnrd Pb. � Paae ; . � I` �:�v �r`�on o� `iie resid�ntial s�cture or the land, not eze�iing on� (1) acre t}iat li�il':?'.LZL°_1V SILTTOl1ZS ��.�� SLIllCtU1°_ 15 US� t'A }�TOC�UC°_ 1I1CQI1°_� (1°SCSltY? �1°_ US°_ dfTj COrt1011 Oi ' i11_ DIOG��j' liu��Z� iA DSC,C�UC2 lI7COITE a=.-r�� o_he_r COUf�L�?J in F;h.ieh individt.31 v.,�ls or is bvy'ing real oro�.sty: �un � 'Itr:.nsluo I he�l' c� � ify :he aL�v= s`at��nt is `s�ue, o�rre�:t arr3 con�lete. „ A Street P�ess . c�.r�, state air� �i, ❑..a�ur_ `� �l n_r a..•ns or is �yuig uner a contract th�it piovids h° is tn pay th_ ��,����3on t>>e residetice, or has a kp-nnficial ititesest in t]i� tiar.�aYer. OCI 1 �� lyo:; - FOR ASSESSOR�S USE OP;LY - ��-�.�'•i72�.r�no) acre in��di.ately Is�ti no� �f��9 stir_*ot�rr3ing re=-zd2ntial i�-c�=v��nnts 0���' L�ul 'i'otal L�-uid P�sici�ntial L�p��mmnts R�elling (1) �z) . (3) (4) Garaae (5) Tntal (�) Trus Cash IUSess�i Valu° Valuation Q�`�'.�T ZI1i�TC7VH'il°I7�.5 � `7> — 1C � Ii�c�ro�����ts - Ii_n_ (G) plus (i).eauals (fl) (�) _ :�rea� c�*'``iy ��e aLro�� is tst:e, correct, and catmlete. Sz�, �ti:re er z'ssessc� - ACTI011 F�l' UUDITnR - . : -�;�� _:: �� �� � � ��� � uat� : _ �/ /� �� r; /� � � � � /// � C.a� .; OQ��v-