Homestead_Garrett (11)CLAIi�1 F08 HOtriE3TEA�`PROPERTY TAX CRE�IT FOR YEAR 19�
SEE'8,4CK FOR FILING INSTRUCTIONS �s'_�(�S9
�,. (we) � ',�C�j�,�;'j� certify .thal on lhe 1st day ol
Ma�ch„ 19 , I, (!:✓e oroupiedJas our priricipal place of residence the following described reat properly lor
�vh:�. Homestead Property Tax Credit is. hereby being claimed: ,'
I, (V�,,, ❑ owned
❑ are buying under contract - OOS O b�OSy'
. ❑ ha0e a. beneficial in�t/e�r��,s�,t�. ,in the taxpayer
Property. Description in �^'C 1� Couniy � Township
Tzxing District (City, Town, Tov✓nship):
Parcel i�umber' or legal description shown on lax statement:
- - �� �/a� :ti'lc;�'/� i�-3-i.�_...�v:�:.
�i buying Ofl contract: Owners name ��ee simvie o..�e�� ��-/�—���—/Q�:�QQQ• /�S9 'Qp�/
4��
, Contract recorded in Recorders Of(ice - Record No Page '
If any portion o( the residential structure or the land, not exceeding one (1) acre lha,l immediately surrounds lhat
structure is used to produce income, describe the use and portion of ihe property ulilized to produce income
Any other counties in v+hich individual owns or is buying real property:
I.��reoy certi(y the above statzment is true, correct and complete.
County Township
u
`'� , Slreel AdCress � � � Gly. SI�iP anE Ap CWc
� ;
Indi��riu21 eiiher owns or is buying under a contract that provides he is lo pay lhe property laxes
o� tpe residence, or has a bene(icial interest in lhe taxpayer.
:- ; ; �� {,
r: . E :
- FOR ASSESSOR'S USE ONLY
F EB 21 199��
nd no� exceedin'g'_�;v!(one) acre irr�mediately
rroundir�g re ,denti �p rt'�
her Land AUDITOR .
�:al Land � � �
sideniial Improvements Dv�elling
Garage
Toial
(�)
(2)
(3)
(4)
(5)
(6)
True Cash
Value
her. �mprovements ��1
�
�ta'. ��vemenis - Line (6) plus (7) equals (8) (8) _
here�•y ceriify the above is true, correct, and complele.
ndlvtC OI Asifi50t ' '
' - ACTION f3Y AUDITOR -
(� �i�vnz_ 1�. . %-�e- _ _
Assessed
Valualion
�5
f IUIIICSIC��
valualion
u:��,� -- ---- � -
a/a� �q�