HomeMy WebLinkAboutHomestead_Garrett (4)FORM HC 70 7979 ��
Prescri6cd By Sute BoarG ol Taa Cammissioner5
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�
SEE BACK FOR FILING INSTRUCTIONS
To & FileG in Dupliwte
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�'(We) � certify that on the 1st day of
arch, 19� I, (We) occupie as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned ' ��_/�i9-o�0�J—�OO.li7� ��
❑ are buying under contract
❑ have a beneficial interqe,�st in the taxpayer
Property Description in �d�-a++-- County
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners
%�n-o--ri-�
or legal description
G� ��� /L�E ��`f
on
i9- � _�.
Township
statement:
8/� �.S�IJc.
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:
I hereby certify the above statement is true, correct and complete.
Strrei
County Township
City. State antl Zi0 �e
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on ihe residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one�e immediately
surrounding residential imp em�t� � �
Other Land
Total Land
MAY
Residential Improvement� 1 ��81 Dwelling
' �. Garage
.4UDITpR Total
Other Improvemenis
Total Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct, and complete.
L �� z�-��
Signamre ol Assessor
True Cash
Value
(i) .,�oo
�2� � o �# `%o
(3) o� Bq_Q �
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�4� y� $ ' f0
�5� 'r L o
�s� 5� o 0
�7� /oGo
�g� G G 6 0
- ACTION BY AUDITOR -
Assessed
Valuation
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Homestead
Valuation
3- 9-8i
Oaie
Date:
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