Homestead_Garrettwwn xc ia ism
ReuriEed By State Board o� Tax Commissianers
CLAIM FOH HOMESTEAO PROPERTY TAX CREDIT FOR YEAR 19Z�
To & FileO in DuDlicate
SEE BACK FOR FILING INSTRUCTIONS MS ���� "
J?' �� � W
,;We) ��"! -- , f —�' r—�� certify that on the 1st day of
nAarch, 19 79 I, (We) occupied as our principal place of residenc�the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned �.�� �7-ol�Q -�Q�.�7CO'do"�
❑ are buying under contract
❑ have a beneficial mt resot in the- taxpayer -
Property Description in��—�—�✓ County q�-. � � Township
Taxing District (Eiry�Fc�uui,.Township):�� 1 ' � ' �
Parcel Number � "
If buying Ofl contract: Owners name ��re simole owner)
or legal desciiption shown on tax statement:
�T. .�1l� v / 9- � -/� �-� a-c..
Contract recorded in Recorders Office - Record
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:
certify the above statement is true, correct and complete.
i/` a`'/
acree� naaress
County Township
ury. am�e ana up cooe
' 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.
- FOR ASSESSOR'S USE ONLY -
Land not exceedi�l one) re ed�r
� � �
surrounding residential improvements
Other Land '�`'�'t`
� �g%9
Total Land
Residential Im r e s����,��`�1 J
au�iroR
Other Improvements
of
Approved
Dwelling
� Garage
Total
irovements - Line (6) plus (7) equals (8)
certify the above is true. correct. and complete.
True Cash
Value
(1) -� o-b
c2) 'S' o a-v
cs� �%5a o
(a) 3'y:� D
(5) — a '—
(s) .� 5� v�- o
��,- � a �
c8� ��
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
�s.
'=/D-7
Da:e
Date: " — �— 7 /