HomeMy WebLinkAboutHomestead_Kruse (2)wun nc ia i�v
Prescri6e0 By Sinte BaarO ol Tae Commissioners
To & FileO in Duplicate
CIAIM FOA HOMESTEAD PROPERTY TAX CHEDIT FOH YEAR 19Z
SEE BACK fOR FILING INSTRUCTIONS
1�(We) �i/�-�i �-Q-�- � v�"-� �%• certify that on the 1st day of
��arch, 19 79 I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claime� z 3��� /
� 6-� Q-/F - 36 3 � ��
I, (We) ❑ owned �//��O �� � �QO
❑ are buying under contract �
❑ have a beneficial interest in the taxpayer �� • �
Property Description in ,�-�-�^- County _�'�'"� Township
Taxing District (Gity,-Town, Tavansk�ip): ��- ��`-¢-"�`-��
Parcel Number
If buying Ofl contract: Owners name ��� s�moie owne.l
or legal description shown on tax statement:
7J�.e-�� Q�e�. �� 7�.
Contract recorded in Recorders Office - Record No
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
Ciry. Siate
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.
t� a��OR ASSESSOR'S USE ONLY -
��
Jl7N 7 1979_
Land not exceeding 1(one) acre immediately
surrounding reside ,r �ry��i����
Other Land � t.-- t r!'�
Total Land
Residential Improvements
Other Improvements
�
True Cash Assessed Homestead
Value Valuation Valuation
(�) %00 ��o
(2) —
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1 � '
sr`�j�j������
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,
Ta'-' Improvements - Line (6) plus (7) equals (8) (8) �`s
I-�by certify the above is true. correct. and complete. �
Signa:ure ol nsxsm.
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Approved:��� /S�o�� Date:w���-, 0 7f -!�?;`�,