HomeMy WebLinkAboutHomestead_ScottFOflM HC 10 1979
Reuribe0 By Slatt Bwrd o1 Tas Cammiuioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 �o
To & FIeO in Dupliwle
SEE BACK FOR FILING INSTRUCTIONS �S � O�Sb �i
�(We) �, `�"�'����- ��� ceriify that on the 1st day of
March, 19�(2, I, (We) occupied as our princip place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I. iWe) L�owned �� ��-�-��-�� .�csC-�o��
❑ are buying under contract
❑ have a beneficial i terest in the taxpayer
Property Description in � C,ounty�
Taxing District (�+i�y;-Iewn; Township): /'/�
Township
Parcel Number or legal description shown on tax statement:
�f �- �c� i� � - 3- ��, /�a � A.
If buying on contract: Owners name �'� "'^o'e °'^^ef�
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:
'Signawre
certify the above statement is true, correct and complete.
Sneet AOCreu
County
Township
y7�o(as�
acaie aw up woe
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 Lantl
Total Land
Residential Improvements Dwelling
Garage
Total
Other Improvements
T'r�lmprovements - Line (6) plus (7) equals (8)
I��by certify the above is true. correct. and complete.
Signawre of
True Cash
Value
Assessed
Valuation
Homestead "
Valuation .
- ACTION BY AUDITOR -
3-3-80
Dare
�
Approved:-/��il �c.�°°.u-o Date: %2�cN.• io, I`%So _