Homestead_Robinson (5).
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FOflM HC 70 1979
Preu�ibetl By State Baara at ia. Commissioners
CLAIM FOR HOMESTEAU PROPERTY TAX CREDIT FOR YEAR 19Z�
/ "
, (We) .
eiarch, 19Z�, I, (We) occuF
which a Homestead Property
E
To Be FileE in Du0licate
405 ' ols►S
�-�'F-�y�-� certify that on the 1st day of
as our principal place of residence the following described real property for
Credit is hereby being claimed:
I, (We) ❑ owned �'G �/'D� a3��QO�•J/� O�f
❑ are buying under contract
❑ have a beneficial in e est in the taxpayer
_�"� Township
�-�.e�-..-1
Property Description i
Taxing Disirict .(C�+y, T!+ �w^ Township):
Parcel Number
or legal description shown on tax statement:
� S 41 � /- 3-/� . 775 m.e�
If buying Ofl contract: Owners name ��� s""o�e ownerl
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
... . D � n
County Township
antl Zip CWe
' 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 1(one) acre immediately
surrounding residential improvements
Other Land
Total Land
Residential Improvemer(�3� � A �
�� �
JUL 27 i979
Other Improvements ,
T � � Improvements - L�6)
I�,by certify the ab i5�
�vellin�
Garage
Total
� e ual )
c rrec . n complete.
True Cash
Value
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(2) — o —
(3) � -1� d
(4) � ���D
(5)
,6, i9 a o
(�) — ° —
(8) ��
- ACTION BY AUDITOR -
Assessed
Valuation
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Homestead
Valuation
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Date: �" 02 � � �p