Homestead_LowryCLI11f�i FOR HCi��STFJaD Pf�O°r7�TY TAX CR7lIT FOP, 'r�tAR 19 ��
SEE i3ACK FOR FIL1tdG It•lSTRUCi10IdS ��j �bIOS �
;,'.-„�_) � c�rEify that on the lst dap c
� ch, 19 I, (j'�°) �'=�i as our p incioal lace oi residence th° follaaing dscrib_d real
�ic_rty ior which a Hoir�stA Pro�sty Tax CY t is hPSeir� b�sng clain�ci:
I, �•�e) [�o..•n�i o��=/Q�-Q3-.�`46-{6/. ���.- 6�-�
� are bir�inq urrier contract
� haw_ a bA._neficial interest in the tah9ayes'
p�o�z-ty Lbscription. in
Ta>:inq District (City, Ta��n, 'Ib�'nsltip): 7/�/�,
Ta��l e �
��sc�l I��nno°� or legal�scriotio�s}�»n on tax statanent:
P��.� �y P��lz.� !� �-3 �r �.� ys
I= bu.�ina o� �ntract: C�an�ss n�re (�ee sirr�le cr�mes)
- - Co;«ract r�.rord� in P_°wrd2r's O_�ice - F�cord ti�. Page
I` any mr`on of `he residen�ial stn:c''�ure or :he land, not °���inq or.e (1) a�e that
irto-�diately surrowus that s`sucture is used to produce incrnw_, d_scrib_ the use a�r3 oortien o_
the PIUF=_Ltj' uti.lized to predu� ir�orre
pn��� otiier c�unties in �;hich individual ah�ns or is bu�+ing rA.-al pro�_rty:
c-`�iPy � a1���e s;atErent is true, mrre:�t ard con�lete.
�,at, tk.��, �-x� / 9
CbtmtV Zv:rnsYuo
, ,�v �r- sc�t� �a z� � �
��a Street F�dress �'� P
*Individ�l °it}n_r a•+-ns r is �uying tm°r a o�ntract that pro:�ids he is tD oay `h_
p�e�sty t�x�s on ''�e residence, or has a b°n°sicial intnrest in the ta�:cayer.
- FOR ASSESSCH2 � S USE Ot•�LY -
t an� not es:��i.n4 1(one) acre in�rediately
surmurrling, residenti.a�ipir�arovare�ts
Qth..r �{I.a'�na� � �g %
P �
To;�i �a
,noc
P�sidentia!1Flirorovesr��ts R,.ollinq
�: '"� �
<_ • ' a J„
` •::T�°
o�ns �ro�J��ts
Garaae
��
True Cash
Valu_
(1) Sa�
(2) / 90 0
�3� . �'�v�
(4)
(5)
c6� 9 Z zo
��� �930
�� � z„n��� -�� c6� ��us c>> �5 cs� ca) i a� o a
�a o � is tn�e, correct, ascl catrolete.
rs.�,• �s�iry tn� at�,_
Sicnature oi Assessor
- ACTintd ?Y �UDI7nR -
Itssss�3 31ar�s�_�.
Valua`icn Valuacic
/?o /70
6 3 0 %//"///�%/i'%�
�o o ��'�� %//,/%!'!;
�� � ���� �� ���i� i
% �� � �� '�
3a(,o 3alno
9'7 0 %% �//%/�-
,,,,,-
y a 3 0 � ;�����%�
Date
;,;,oro�:�:; �<f �� IiLQ�(�i�l� Dat�: y l� ��