Homestead_McCloudI�i FOR NC���STEI�J Pf�O°�tlY TAX CRrDI7 FOR 'ftfiP �9g� ��yLd��' ScE BACK FOR FILltd6 1P;S7RUCTIO�JS Z, '-.,.a�) 1� �Q.u.-.... � 0// �(�rt�.L �tifY tha*_ on t}ie 1st da; �+3rch, 19 Q, , -��i� � our princi.Dal olace or residen� t}:e fol].a�ing desQib�d ry Q� p�rty ior �•%nich a il�r�stea8 �op�'sty Tax �edit is herelr� bA.ing claured: Z, (i9e) �i a.t-n�-si � are biry+inq urries contract � haw_ a b�.n=ficial interest,in the t�ax-�yer Proc_rty D_scription. in /�/ Gv�i�, ���� Ta.inq_ District ICity, To�m, �`ip� 7.�_. �s� 0� 7� pp 7��-oa 'Ib.,rs ��r.�l tiL,-�ic��s or legal des¢iption sho'w'n on tax statQ�.st: �j�'/�. %)� /� �,z-�-lo �f— I= bu.•ina en wnLLact: Oc•m_ss n�re (fe° sirr�le o��m:s) - - Con�ract rE.:ords3 in P�corder's Ofii� - I��cord tl�. Pag= Z` an}' �or�ion of the residential stn:cture or the land, not a��e�ing or.e (1) acre that i,-rm-=dia�ely sun��s �iat s`ructure is us� tn produce inca�, d_scrib° the ws arrl oortien c tne oro�sty utilized to pmduce irrorre - ^ - - - i., ., e �— pn:y' o�er cai:nties in o:hich indic�dual ocans or is bui�inq r��l proo�.st��: Cbun�� TII::I'.SIllD T her�y c. -`�if}' the �bOVe stat�mnt is �� (����, � �'�-�-�-� _ true, �rrect arri con�lete. Q�- N-� %�tx 333 .�iu ocr nrinraca .. . C1ty. *Individu3l eith°r a�'ns or is bsying wzer a contract that provides he is � nay �,�i_ p���• ta,ties on t]i° residence, or has a ib.�eficial intesest in th° tar.oayer. - FOR ASSESS(NZ�S USE ONLY - Larrl no����� �� acre inu��cliately surrour�i ng rocarents °``�'°r �''� APR a 1986 To�i ��a �� } P�siderkx�l ro s �'-`�°�lT04 Dw?ZZu1G Garaae True czsh Va1L� (1) .�oo (2) < �.o 0 �3) / 7 00 (4) (5) Total (6) 3 //!oo Qtn,s Ir •rilrovan�zts t7) / a G D 7'c � Ir�rwerpsits - Line (6) plus (7) eau3ls (B) (8) .3� S�zo � I hece�}� c�rtify `,ne a�av°_ is tn:e, correct, an3 �nc�lete. Si�iatur° or Itissssor - ACiIOW ?Y AUJITnR - t�ssesss3 Sk7r.�s�: Valuaticn Valuac a `% o o ����j%�/� S7 a ��%���j//.i, �� � ����% �����%�i % ��L�LL�� / ���// � 1o39n /0390 � o %j ///,/�% lO $/ O 1//��// ce //! 1 Date: �T, l9�ce i+^� �v�' : �11 /� ( /2-�...c.