Homestead_Barton (6)runr. ub �U b,'i •,a iJrJ m Ciq�pi.:Jr
P¢u�i0ea By S�ate BoarC ot la, tommissioners � ���_�
' Q��r
� ' CLAIM FOR HOMESTEAD PROPERTY TAX CREOIT FOR YEAR 19 C�
';' ''=; " � SEE BACK FOR FILING INSTRUCTIONS ��_ �9-�9 -/��-�� a�� -
_�e1 �T � � r�� ��^ �� certi(y that on the 1st day of d��
,.rch, 19—=� occupied as our principal place of residence the tollowing described real property for
which' a Homestead Froperty Tax Credit is hereby being claimed:
1,. (We) M" owned .,.
� "��'� �` ` �� ❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Township
Taxing District (City, Town, Township): I.IMA[`IXl
Parcel Number : or legal description shown on tax statement
�;_ ,.�
- -. �f�,' i� 1'U(,<r��y �'-3-JO s,00�q�...
If buying Ofl contract: Owners name �1ee s�mPie o.oeq
_ • •� Contract recorded in Recorders Ofiice - 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 o( ihe properh� utiliz�d tc prediicr incom�
Any other counties in which individual owns or is buying real property:
��reby certify the above statement is true, correct and complete.
County Township
, . . a��ee� ruu�eas � eiry�. siaie ann Lo Cone
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a bene(icial interest in the taxpayer.
� ' - FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residential improvements
Other Land �
Total Land
Residential Improvements
Dwelling
Garage
Total
Other Improvements
Tot,�provements - Line (6) pius (7) equals (8)
I he�eoy certify the above is true, correct, and complete.
Signalure ol Assessor
True Cash
Value
(�) _�iSO O
(2) a I O o
�3� S(� � �
(4)
�s�
,6, a(�800
(�)
�
- ACTION BY AUDITOR -
,
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Assessed
Valua�ion
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D:ei
Homestead
Valualion
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8�30
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