Homestead_Scott (3)FUHM HC 10 1979
PmSCriEeE By Srote Board af Tae fqmmissioners
CLAIM f0A HOMESTEAD PROPERTY TAX CflEDIT FOR YEAR 19�L
To & Filed in Duplicate
po5 - p I 583
�(We) U � G- " �� u^x'`'�certify that on the 1st day of
viarch, 19Z�, I, (We) occupied as our princi I place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed: '
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial ir}ter�st in the taxpayer
Property Description
Taxing District {�ity;-�ew�, Township): //��a
Parcel Number
If buying on contract: Owners name ��� simple o.�e,�
o��-/O-o?�- �G-OD/. S'd�� -O�/
Township
g�2 a��e A
or /le�jal descriptiFfn shown on tax statement:
'C�S�;u o3l0-0�'/� /�s�-;
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.
�.
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 1(one) acre immediately
surrounding residential improvements
Total Land � � �+ � �
Residential Improvements �; Dwellin
JUN 2� 1979 s
' Garage
�� ���u�2� Total
Other Improvements AUDITOR
Tn� � Improvements - Line (6) plus (7) equals (8)
I�Gyi�ertify the above is t,�ue; correct. and complete.
True Cash
Value
(�) .`� a a
(2) / �' U
�g� � � O
�a� (n 7�0
�5� � � o
(g) % C�i f) O
(�) / .�-v
(g� / .3 6
S
Assessed Homestead
Valuation Valuation
/7 D �7 U
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Date: ---��`�