HomeMy WebLinkAboutHomestead_BaumgartFOftM HC 10 19i9
Prescri�eU By Siate Bwrd ot iaa Lammissfoners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�
Ta Be FileO in Wpbcate
SEE BACK FOR FILING INSTRUCTIONS
�p�! ��Dj� fG - DO
�(We) ��� - certify that on the 1st day of�
arch, 19��, I, ( e) occupied as our prin al place o residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed: . _
I, (We) ❑ owned ��-�a-�a /�-oa� D�-Qas�
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �/-1+� County Township
Taxing District (6iiy-Taw�, Township):
Parcel Number -. or legal description shown on tax statement:
Pf• ��. Lrla oZ � h�-// ,� .S � 4=-.�0
If buying on contract: Owners
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.
• .
�� � - �
'Sign e reec Aaaress Gty. State an Zio �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 -
Land not exceeding �one�acre�imme�el�
surrounding residentiai imp vem�TRts
Other Land J�r� t 9 1979.
Total Land
Residential Improvemept�f /��/����� •--�'—Dweiling
�� �
AUDiYOR Ga ar ge
Total
Other Improvements
TM � Improvements - Line (6) plus (7) equals (8)
lioy certity the_above is true. correct. and complete.
O� A552SSOf
True Cash
Value
�i� 3 00
(�l / �!o 0
(3) / 7 (00
(4) /a SIAc
(5)
(6) _/� yPo
(7)�070
�a) i .3-�'S-o
- ACTION BY AUDITOR -
Assessed
Valuation
0
5/ d b
Homestead
Valuation
/ Jo
,5-/9- �9
w:e
Approved: //'� � -�-' � �a� Date: � —��—� /