HomeMy WebLinkAboutHomestead_Bittner (5)FOqM HC 10 1979
�ResaiEeE By State BoarO of Tan Cammissioners
CLAIM FOR HOMESTEAD PROPENTY TAX CREUIT FOR YEAR 197�_
To & FileE in OuD���ate
�(We) � � •°� certify that on the tst day of
arch, 19�2, I, (We) occ pied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is Fiereby being claimed: yoa� o 9� aa 5�
I, (we) Lld" owned d�,�g�(' 35
❑ are buying under contract (�/ �/ ��A� /�—Q V
❑ have a beneficial interest in the taxpayer
Property Description in ��f-�.-�-�-�- County �� -e�-�� Township
Taxing District (C-ity-�o�vn, Township):
Parcel Number
If buying on contract: Owners
or legal description shown on tax statement:
Pf. S� SEy _�.s = 3-// ///• 73�...�a
Contract recorded in Recorders Office - Record No
If any portion of the residential structure or the land, not exceeding one (t) 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
i,hereby certif the above statement is true, correct and complete. "— '—
��� ���
��,s�u,,.... o� %�i B:_�,...o..r' �� �` � �eYy 6 7 �-�-�a�� .�-� X 763 9
Signamre Slr¢¢t AOE�ess Gity. State an0 Zip Cotle
' 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 exceeding 1(one) ac im ed�telyE
surrounding residential improv�nt�' jJ (�) s'o 0
Other Land
Total Land
Residential Improvements
Other Improvements
JUN 11 i979
��/��R
AUD�7a�2-ge
Total
�Tn+ i Improvements - Line (6) plus (7) equats (8)
by certify the above is true. correct. and complete.
: .� � n e
(2) �Z�/� _�
cs> a s_a 9 0
(4) 5� % 30
(5) �
(6) �/ 7 3 0
(�) / 9 � o
(8) (o (a i O
- ACTION BY AUDITOR -
Assessed
Valuation
�
�
J / l
Homestead
Valuation
E�LL'
��.2/-7�%
Date
Date: � �