HomeMy WebLinkAboutHomestead_Karaffwarn nc io iem
Reuri�eE By Sute BaarE of Taa Commissianers
To Be FileO in Mplicate
CLAIM FOR NOMESTEAD PROPEHTY TAX CREUIT FOR YEAR 19�2
SEE BACK FOR FILING INSTRUCTIONS 4//_ DD �Q e� �OO
�(We) � � i�� op- ✓-�-�1- � certify that on the 1st day of
arch, 19�`" , I, (W ) 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 inteQre{st �in the taxpayer
Property Description in ✓�^-�-r^ County �-m Township
Taxing District (�i�y,- Town, �ewnship): �/� • � h-�� ��-
Parcel Number or legal description shown on tax statement:
o� d-t�,�e. �,a� oS��'t..�. �cQ � 3 /
If buying Ofl contract: Owners name ��ee s�mo�e ownerl
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.
l��� �K�
�T.�,..� �l,u,�.�� ��,�o � s ��. , r'� . �,., � ��...�, . �., . ����x
' Sgnature / '� Sheet Aadress Gry. State ana Zip CoCe
' 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 exceedi���c� rt�tely
surrounding resi I m overli$hts��
Other Land �
Total Land
���
Residential Improvements
�
� _
1/
Other Improvements
� i979
A�
True Cash
Value
(�) ��.o
(2)
Assessed
Valuation
�/o
Homestead
Valuation
a./o
. � - ��������
�������///�� �������/
1 � _ , ������ ��/j�
'� /�ii�Se��i;! /%/Lyii.��.,:�/�
..�•
_ i � • r _ � �
1 . �����������������
To� ' improvements - Line (6) plus (7) equals (8)
I,�y certi(y the above is true. correct. and complete.
. r. �-- � _
Sigwmre o1 nssessor
e
(�)
�g� o0
iniTna _
--�
�800
�'- z3-7�
Dare
Date: