HomeMy WebLinkAboutHomestead_Richardson (5)�
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keuriDeE By State BwrO o1 Tax Commissianers
To & FiIW in Dupliwte
CLAIM FOR HOMESTEAD PAOPEATY TAX CREDIT FOR YEAA 192`�
SEE BACK FOR FILING INSTRUCTIONS
��We) ���� • �• �' �1� /C • certify that on the 1st. day of
arch, 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 V// DV `O �" O�
❑ are buying under contract
❑ have a beneficial inte�rest Iin the taxpayer
Property Description in ^�-^�°�— County _ � Township
Taxing District (Cit�-Town, Towtuhipl: �
Parcel Number
or legal description shown on tax statement:
/ 0
If buying Ofl contract: Owners name ��� �""o�e owner� f'�YST �! O✓sA Q:J:.�a �— CO �'� hw�Y,
Contract recorded in Recorders Oftice - 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: County Township
�
hereby certify the above statement is true, correct and complete.
��
��, r � � �... �'a� � Ir �y r ,T �' �f7
igmmre Shret AQOress City. State ana 2io W�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 -
True Cash
Value
Land not exceedi 4(� � i iately
surrounding �ide�tial IA�pro�en� (� ) 5� 3 0
Other Lantl �� �� (2) —
Tota� �and ��N 1 9 i979
Residential Improvement ���t`"'Y"'" –
l t e J� I
� AUDITOR
Other Improvements �
(3) S 3 0
Dwelling (4� �
Garage (s1 � ° p�'O
Total (6> '�'���
��� --
To'�' Improvements - Line (6) plus (7) equals (8) (8) '�`f"°�3b
I��y certify the above is true. correct. �nd complete.
Sigwmre of Assessor
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
�– 8 0
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Date� ° � � � 7 �