Homestead_ZehnerFOflM HC 10 1979
heuribeE By SWte BoarO ol Ta� Cammissioners
CLAIM FOA HOMESTEAU PROPERTY TAX CAEDIT FOR YEAR 19�
�bs-oi9�3
To & FileE in OuD���te
SEE BACK FOR FILING INSTRUCTIONS
r` - � �
�(We) �' certify that on the 1st day of
arch, 19�, I, (We) occupied as our principal pl c 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 ;nt�rest in the taxpayer
Property Description
Taxing District {�ily-�ewrr,—Township): �' �`—Q'
Parcel Number
If buying on contract: Owners
�a'� -/�-�7-/oa�/1�'7�3-0�/
`.��c,zn.,,�c.�-! Township
or legal description shown on tax statement:
�. N�� �-3—i� l/.5`d�.
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: County
' hereby c rtify the above statement is true, correct and complete.
�- � l� � D _
Township
City. Sute'ana Zio �e
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or s a beneficial interest in the taxpayer.
�T �- ESSOR'S USE ONLY -
�
MAY 2 � �9�9
Land not exceeding 1(one) acye�i�di t y
surrounding residential impri�fe
Other Land /� AUDIT�R
1/
Totai Land
Residential Improvements
Other Improvements
Dwelling
Garage�
Total
provements - Line (6) plus (7) equals (8)
'i�ertify the above is true. correct. and complete.
True Cash
Value
( � ) S a--u
(2) % % � v
�s� f� �' o
c4) 18'93 0
(5).
(6) �' .3 D
(�) — ° —
�a> B' 3�
- ACTION BY AUDITOR -
�76� s�
Assessed Homestead
Valuation Valuation
/ 7 d
ii
� �
s-a�-79
Da:e
Approved: � �i /� Date:���+ �k%�:197�