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Homestead_FieldstUNlA FL Ip IYl9 Piesc�ite0 By Sta�e BwiO oi la. Commissioners C�AIM FOR HOMESTEAO PROPERTY TAX CREDIT FOR YEAR 19 �� �� V ' `' SEE BACK FOR FILING INSTRUCTIONS n3'.: ��:..:' 66S-OOSBS a° V 1�1 -,a ^ ' '�°� JVtil .! � � , IXXC�C/-�-1 Ne) � erti(y that on ihe tst day of ch, 19 I, (We) occupied as our principal place of residence the (ollowing described real property tor which a Homestead Property Tax Credit is hereby being claimed: I, (We) owned �L -�D -.J.�- /O�—�� S�� Q�� ❑ are buying under contract ❑ have a beneficial inter t in the taxpayer Property Description in ��-�� County ��l�%YS Township Taxing District (City, Town, Township): Parcel Number or legal description shown on tax statement: , �. S.F.I/� -33 I( buying Ofl contract Owners name ��ee vmoie owneq . Contract recorded in Recorders O((ice - Record No. � Page ��QS— If any portion o( 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: by certify the above statement is true, correct and complete � County � � Township ;V, �(e 7,(J o�y��e.o . .. , . _ . . ....... . ............ Cl�p. S�:ve .�w�Z�p C«�c '-Individual either owns or is buying under a contract that provides he is to pay the property taxes on the residence, or has a bene(icial interest in the taxpayer. ����� - FOR ASSESSOR'S USE ONLY - i APR 1 a 1989 Land e g sacre immediately surroun in ���rovements Other Land Total Land Residential Improvements (�) (2) (3) Dwelling �4� Garage �5� Total �6� True Cash �ssessed Hornestcad Value Valuation Valualion Ot�mprovements ��1 To 4nprovements - Line (6) plus (7) equals (8) (s) I h y certify the above is true, correct. and complete. Sigmiurt ol nsseswr - ACTION BY AUDITOR - � /%/ o;,��. APProved: l�t��(-� +� - / / I ���� Date: _ __l_I �_-L I � -/ --