Homestead_Powers (2)wun xc �o �en
NescriGed By Sute BoarE ol Ta. Cammiuioners
CLAIM FOR HOMESTEAD PROPEHTY TAX CREUIT FOR YEAR 19Z�
SEE BACK FOR FILING INSTRUCTIONS
which a Homestead Property Tax Credit
To & FileO in DuD���ate
�` p� $ -6(`I I �
I��-•-=�� �- ° -certify that on the 1st day of
pal place of residence the following described real property for
reby being claimed: �
I, (We) OO owned -
❑ are buying under contract '
❑ have a beneficial�t�s�in the taxpayer
Property Description
Taxing District�{�ily-�owr,rTownship): ��
Parcel Number
If buying on contract: Owners name �'� simo�e owner�
�C-/� o9-/ao,00% �ia-aa-�
!/��`%��-_-�-� Township
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or le al description shown on tax statement:
� r� � y 9- �- i a aa.-�.--
Contract recorded in Recorders Office - Record
e
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
�•
streec
County Township
Ciry.
' 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
.a Value
Land not exceeding 1(one) ac�'im� ediatelv � �
surrounding residential improvements" �i" (�) � �
Oiher Land (2) � ��
Total Land JUN 1 Q 1979 �3� / o0 0
Resitlential Improvements
Other Improvements
/� � • i�%,
.�
� ����-
,.
To'�' Improvements - Line (6) plus (7) equals (8)
I��y certity the above is true. correct, and complete.
S�gfa:uri b� nssessor -
U
Approved:�_
(a> �35- a
(51 - ° —
cs> `f3So
�>> - � -
�a� �3.�"0
- ACTION BY AUDITOR -
Assessed
Valuation
.
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Homestead
Valuation
/7 0
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,5 -/�-79
Date
Date: /` �