HomeMy WebLinkAboutHomestead_Bertram (2)weM Hc io �s�
Rescri6M By S�ate Board ol Ta. Cammissioners
CLAIM FOR HOMESTEAD PROPEHTY TAX CREUIT FOR YEAR 192�
To & FileO in Duplicate
(� � o�- �
�(We) ��u � �- a-r- `^�' ��'� certify that on the 1st day of
arch, 19�r'�, I, (We) oc pied our princip ace of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed: �—�OD_OOO•�nv_��./
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I, (We) ❑ owned ��� ,Q — QQ
❑ are buying under contract D��V
❑ have a beneficial intere,�t in the taxpayer ^ �
Property Description
Taxing District (�6kq; Tewn; Township):
Parcel Number
If buying on contract: Owners name ��� simple o.,�e,�
nty
Township
or legal description shown on tax statement:
�• St ly ,� P�. Sco� 3G �� �/o i o y�.,�,
Contract recorded in Recorders Office - Record No
Ii any portion ot 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.
�
s.reec naaress
County Township
ury. a�ace am �ip woe
' Individual either owns or is buying under a contract tha[ provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
F.�R ASSESSOR'S USE ONLY -
� � � � � True Cash Assessed Homestead
` ��,q Value Valuation Valuation
Land not exceeding 1(one),�ac�e �immediately ,
surrounding residential improvements
Other.Land �
Total Land �'� qUDITOR
Residential Improvements Dwelling
Garage
Total
Other Improvements
Improvements - Line (6) plus (7) equals (S)
qy certify the abqve is true. correct. and complete.
Approved
(�) _5—o a
(2) ,�/3 A�
(3) � / d�' A O
(4) �/ `1aa
(5) d o 0
(s) � i zo
(7) / % �2 0
(a� � � 5io
- ACTION BY AUDITOR -
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Date: �` l