HomeMy WebLinkAboutHomestead_Hardiman (2)FONM HL 10 1979
Presui�ea By Staie 0oard al ia. Commissioners
CLAIM FOR HOMESTEAU PROPERTY TAX CREOIT FOR YEAR 19 79
ia & FileO in Duplicate
SEE. BACK FOR FILING INSTRUCTIONS OQS '�,��
��(We) �--=,y ������ ���-�' -' � certify that on the 1st day of
�arch, 1972, I, (We) occupied as our principal place of residence the following described real property for
which a Ho estead Property Tax Credit is hereby being claimed:
I, (We)�ned ,Q
❑ are buying under contract ��'// �` -��' ��• ��— �°��
❑ have a beneficial iqterest_ in the taxpayer
Property Description i
Taxing District �-�6itq--�awn,. Township): /"�"�k
Parcel Number
If buying on contract: Owners name "� �'"1p1e °""ef�
Township
��
��
or legal description shown on tax statement:
�r, G� <. N£ s� i �- � - y/ � �--�
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:
' hereby certify the above statement is true, correct and complete.
n///f � �p
.X AY n.�CJ�ii,i � �.+� .t J � /� �
Counry
�
Township
Gry. Sta�e ana
' 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 -
True Cash Assessed Homestead
Value valuation Valuation
Land not exceeding 1�,- ene)�acre mme�el�
surrounding residentiaU impr'ovem�s (� ) �°—O � 7 o�,�y���
Other Land
Total Land
n c ty!`�
j::i\ G J _
Residential Improvements
�� welling
' Garage
AUDITOR
Total
Other Improvements
Improvements - Line (6) plus p) equals (8)
by certify the above is true. correct. and complete.
o� Ass¢55pr
Approved
� . ,� --- -
i � � � � � �
� ;:����������
+ j��jjjj/
• _
:
i � - �w
�
� � • i
���� lf�l 1 ���
S"-i/ -
Date
/ �—f�
Date: �