HomeMy WebLinkAboutHomestead_FrohbieterFOAM HC 70 7979
PrescriGeE By Sute BoarE ol Tae Lammissioners
CLAIM FOA HOMESTEAO PROPERTY TAX CREUIT FOA YEAR 19�
SEE BACK FOR FILING INSTRUCTIONS
To Be file0 in WDliwte
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Ne)-� ��-�/k� �'�-�-K—� J certify that on the 1st day of
nnarch, 192`L. I, (We) occupied as our principal place of residence the tollowing'described real property for
which a Homestead Property Tax Credit is hereby being daimed:
I, (We) � owned
❑ are buying under contraci
❑ have a beneficial i�est�
Property Description i
Taxing District {6ity,-Taww-Township):
Parcel Number
��-/� /7- do-DaD. �3� _��/
the taxpayer �
�County � ��-�1�Township
�ii�r-z,�m i--,.,,lirc.l
If buying on contract: Owners name ��� sim0�e o.�e��
or legal description shown on tax statement:
pT s w=� s�� / �-3-�/ ��-� _
Contract recorded in Recorders Office - Record No. Page
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
Any other counties in which individual owns or is buying real property:
�ereby certify the abov statement is true, correct and complete.
,r1 _ _� i 1 i o �_ _ � �
.s�- z, _ 7R
Aadress
County
Township
ana Zip CoCe
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOfi ASSESSOR'S USE ONLY -
Land not exceetl� � 1 acre immediately
surrounding resid ial m�'ove�s�
Other Land �
Tota� �and h�qy 2 3 jg79
Residential Impr�ments
�
AU��
Other Improvements
Dwelling
Garage
Total
�rovements - Line (6) plus (7) equals (8)
certify lhe above is true. correct. and complete.
OI ASSESSOe
True Cash
Value
(�) �—�.
(2) G lo 0
�s� // � o
(4) —� a �
(s) _/ 7 90
(6) �$' B' D
(�) � / 5� o
(8) � O � d
- ACTION BY AUDITOR -
Assessed
Valuation
,
..65/
.�
���������
jj�j�jj�/
_�
.
i
-z- �
% � �.SJ
Homestead
Valuation
� — i a-79
Dare
Approved: ��/��� Date:;��� % `�