HomeMy WebLinkAboutHomestead_Eads (3)FOflM NC 10 1979
PrewriEeO By S�ate BwrO ol Ta� Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CHEDIT FOA YEAR 192`�.
To & Filed in Duplica[e
/�' SEE BACK FOR FILING INSTRUCTIONS D// �/��OO
�(We) �`�-�' .�`-'-�� certify that on the 1st.day of
�rarch, 19��, 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
❑ are buying under contract .
❑ have a beneficial nterest in the taxpayer
Property Description in �-�-�-��'� �/ C�ounty �%���"'�-�+�- �� Township
Taxing District (Ci1y, Town, Towasbip): , 7/� � /d�-�.
Parcel Number or legal description shown on tax statement:
�,�,�z�.,�,�. /8
If buying on contract: Owners name �'� 5inip1e °'"1e`�
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
re SVeet A�Cress "- � Ciry. Staie anE2ip CoOe
s� 2s=7 y ��� ��
' 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 -
N' D True Cash
y,� Value
Land not exc�din�1 one) acre immediately
surrounding reside�AY i�nRr��e�ents (� ) � 3 �
Other Land -(2) —
Total Land
Residential m ro� ts AUOITOR Dwelling
Garage
Total
Other Improvements
Tr�-�-Improvements - Line (6) plus (7) equals (8)
�,�oy certify the above is true. correct, and complete.
Signawre ol nssessor
(3 ) �' 3 0
(4) �-"�--�/�a"
(5) l 7-�f ,� O
(6) �`�'`�B
(�) �
/ -, . �i�.
(8) �`
- ACTION BY AUDITOR -
Assessed
Valuation
a s�
•
jjj/����j/
:i�i���j/%
p.�,///>-//. ,
�
_.�
Homestead
Valuation
2 80
�
� cS' / cl�% `/'
oa�e �
�
Approved: � Date: !���