Homestead_Rexing (2)FOflM HC 70 1979
Preuribe0 By SUie BoarE ol Ta. tammiuioners
CLAIM FOR HOMESTEAD PROPERTY TAX CHEDIT FOfl YEAR 19Z
To & Fi1M in Dupliwte
doS-6I�(S7
� (We) �-����,� �- ,��—^- - � ��--�-' ��.
described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) �owned
❑ are buying under contract
❑ have a beneficial injerest in the taxpayer
Property Description
Taxing District (6rfy�-�ewn- Township): /, '� t�
Parcel NOmber
If buying on contract: Owners name �'� �'mp1e °'""ef�
01� /� /o-3aa ,G�/ `f.S� ��/
nty
Township
v � �
or I al description shown on tax statement: �n.C�
, cSG�J,�f�� / D-3-// al-�JeZ-2e_
Contract recorded in Recorders Office - Record No
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.
County Township
' 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, -
Land not exceeding�7 (q�)�e�e at y
surrounding residential improvements
other �and MAY 2 Q j979
Total Land
Residential Imp��
AU��
Other Improvements
APP
Dwelling
Garage
Total
provements - Line (6) plus (7) equals (8)
�certify the above is t,�ue. correct. and complele.
True Cash
Value
(�) � ��
(2) S �' 3_t�
cs��33o
(4) 7 7 �"O
cs> 3 5 i o
(6) ��� / O
��� 3G.s�'a
(8) �% 77`i�
- ACTION BY AUDITOR -
Assessed
Valuation
/7D
j���j���
�jjj/�j�j
i
�G"�
Homestead
Valuation
U
� _/ 7— 79 '�
oa:e �
�
Date:
A