HomeMy WebLinkAboutHomestead_AllenFOpAI HC f0 7979 � To & FileA in DuD���te
PrescriDeO By Srote BoarG at Tax Commissioners //�` //�Q�D�� Q�
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CLAIM FOR HOMESTEAD PROPEflTY TAX CREDIT FOR YEAR 19J�_
SEE BACK FOR FILING INSTRUCTIONS
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(We) , o-�+-u-- certify that on the 1st day of
arch, 19�, I, (We) occupied as our principal place ' f 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 in rest in the taxpayer
Property Description in �"°�'� County �� Township
Taxing District (Gity-Town, Towriship): �"'�-� ��"4-��'
Parcel Number or legal description shown on tax statement: . —
(�__�.«. �2t.�t.� �,. fl �
If buying on contract: Owners name ��� simole
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 Township
' hereby certify the above statement is true, correct and complete.
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Sheet AOdreu
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City. State antl Zi0 �e
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 improveme� �
Other Land �
Total Land
Residential Improvements
Other Improvements
True Cash Assessed
Value Valuation
(t) 870
� � (2) $ O
.; UL .'3 p D���ng
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' . AUDITpR
T-" -Improvements - Line (6) plus (7) equals (8)
l�by certify the above is true. correcl. and complete.
Sigra:ure oi nsseswr
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- ACTION BY AUDITOR -
Homestead
Valuation
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Approved: (/i ' �G• <�/.�-( J�.n�Gl�/ Date: /-�G' %9
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