HomeMy WebLinkAboutHomestead_Wade (2)FOfl1A HC 10 1979
PrturiOeG By State BaarG of Ta. Commissioners
CLAIM FOR HOMESTEAU PROPERTY TAX CREUIT FOR YEAR 19 7�
�y��:��y:.�.�:■�
io Be FileO in �uplicate
o�S -O(Ss�
�(We)��� ����-�/�-� '�" �—�"=a� certify that on the tst day of
arch, 19�, I, (We) occupie as our principal place of residence the followin9 described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial inJer�st
Property Description i
��-/7-//-�oG-DQ/ d'� - o �!
the taxpayer
Taxing District (�ity rnwn Township):—/�/���
Parcel Number
Township
���
—��
or le al dest"ription shown on tax statement:
��cJ`Nu�� ��.3-�� �av��.
If buying on contrect: Owners name ��� sim0�e owner�
Contract recorded in Recorders Oifice - Record No. Paoe
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
Other Land
Total Land
Residential Improvements
Other Improvements
Improvements - Line (6) plus
by�certify the above is_truea
True Cash
Value
(1) L5 cr-v
( p � % 6--0
(3) �o O O
' �': ��� ag�} (4) 3�?30
�•'�. � - �araqE�ae � �. (5) — � —
��rt! �°��g
1�',� � %
� • 1 i : : `
� _ �,I � .
v �^ �
Approved:� E�
(6) �
��,�a i�
(8) ��'� d
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
/7d
I D ��"
�_. .
�� i
v '" � r� � 7 /
Da:e
Date:
�d