HomeMy WebLinkAboutHomestead_Peterson• � CLAIm FOR HOMESTEAU PROPERTY TAX CREDIT FOR YEAR 195�!
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SEE BACK R FILING INSTRUCTIONS �
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I, (We) � � (�_ cerli(y that on the tst day of
,�h, 19��, I, (We) occupied as our principal place of residence the following described real property for
h a Homestead Property Tax Credit is hereby being claimed: /
I, (We) owned (�Cv -�� `�� �' ��!_ /a!o -G� �
❑ are buying under contract - , •
❑ have a beneficial inte(e�t in, the taxpayer
Property Description in —
Taxing Districi (City, Town, Townshipj:
Parcel Number, ,
Township
ition shown on tax statement:
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If buying on contract Owners name °Pe ""'°"
Contract recorded in Recorders Ofiice - Record
If any portion of the residential siructure 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 olher counlies in.which individual owns or is buying real property:
I hereby certify the above statement is true, correct and complete.
�n�� �t . �L�./�-o4n� %���a �ox a � 9.D y
Counly Township
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. . . .. . . . . Svcet AOEress . . . Gi�Y. Siaie and 2iv Goee
Individu Y�w�s''tj uying under a contract that provides he is to pay the property taxes
��o� .th�L � id, nce, or has a beneficial interest in the taxpayer.
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- FOR ASSESSOR'S USE ONLY -
APR 2 4 1989
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Land not exceeding 1(one) acre immediately
surrounding.residential improvements
Other Land .
Total Land
Residential Improvements � Dwelling
Garage
Total
(�)
(2)
(3)
l4)
(5)
(6)
True Cash
Value
Other Improvements ���
To mprovements - Line (6) plus (7) equals (8) (8)
I ��� certify the above is true. correct. and complete.
Sigruwre ol Pssessor
- ACTION BY AUDITOR -
App
Assessed Homestead
Valuation Valuation
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Date: � ° - � •"' �
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