HomeMy WebLinkAboutHomestead_Carter (6)wwn Hc io iem
NescriEM By State BoarC ol Ta. Cammissioners
To & FileE in Duplicaie
CLAIM FOA HOMESTEAO PROPERTY TAX CHEDIT FOR YEAR 19 •7i
SEE BACK FOR FILING INSTRUCTIONS
�(We) �, �J ➢` �+-Q-P-e-�- �• certify that on the 1st day of
�aarch, 19�`L, I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I. (We) ❑ owned �// � /j�//� - Q (J
❑ are buying under contract ��
O have a beneficial interest in the taxpayer
Property Description in �^-�-`-�" County �°" Township
Taxing District-(Eitq; Town, Sewaship.): ��-ti-� �
Parcel Number or legal description shown on tax statement:
. , , ./._
If buying on contract: Owners
(lee simD�e owner)
' .2� —� % .d�'" �3'
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:
hereby certifx the above statement is true, correct and complete.
I ��.� � , ��
�» h,, n �-- �_. . 0 _ �l
'Sg�Nre
AECress
County
Township
z�v
' 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) aC��e tely� �
surrounding residential improv� nt
Other Land
Total Land
Residential Improvements
Other Improvements
.JU[� 1 � 1979
t � �;-` .
� � • ��,
� -'+•'.
�.
Tr�-�.Improvements - Line (6) plus (7) equals (8)
I�oy certify the above is true. correct. and complete.
5igm:ure ot
Approved
True Cash Assessed
Value Valuation
�t� 33 �o
(2) �.2�0
(3) 6-6 h�o
(a) �
(5) —
� v'
Homestead
Valuation
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Date: