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Homestead_Ramsey (3)waA+ xc io isrn Aeuribe0 By State Board af Tax Commissioners CLAIM FOA HOMESTEAD PROPEATY TAX CREDIT FOR YEAR 192� To & FileE in Dupliwte ! SEE BACK FOR FILING INSTRUCTIONS. �',(We) �^^^ -d ` � � �p—� � • '1 � �� certify that on the 1st day of march, 19� I,�upied as our principal place of resi ence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) O owned ❑ are buying under contract ❑ have a beneficial interest �,/ - Property Description �' � � the taxpayer Taxing District (6i�y-��_Township): /" �'�n-+ Parcel Number If buying on contract: Owners name (�� SimD�e owner) nty ! /'1�!�v�-> ° ==� Township �,,.._. or legal description shown on tax statement: � .�/ u� � a � - a - � � 3�, 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: �hereby certify the above statement is true, correct and compiete. naareu County Township antl Zip CoEe ' Individual either owns or is buying under a contract that provides he is to pay the property taxes `� To he i or has a beneficial interest in the taxpayer. d69 1 � �OR ASSESSOR'S USE ONLY - MAY 2 3 i97g True Casn nssessed Homestead _ � / Value Valuation Valuation Land not exceedF�tJl1•�ikf�) r e e surrounding residenti improverr�6 TOR (�) � o o �—/ 7 0 7 a r-� Other Land (2) 3 a 7 G�=!-�� �� ��" ���:�,;;, Total Land Residential Improvements Other Improvements (3) � / / C.� ( Dwelling �4> � S � 5 0 Garage Total Tr� Improvements - Line (6) plus (7) equals (8) I�by certify the above is true. correct. and complete. ol Assesso� �5� _ o , �s� /S oS-o ��� — � — o (8) /5 o S O ' �-6—�-0 ; —��-79 oa:e Date: � �- � - 7 (—