HomeMy WebLinkAboutHomestead_Spindler (17)FOPM HC 10 19i9
Pfescri0e0 By State BoarO of iaa Commissioners
to Be FIM in UupGCate
CLAIM fOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 ?�
SEE BACK FOR FILING INSTRUCTIONS
'(WP� ` ������ certify �that on the 1st day of
rvlarch, 19ro I, (We) occupied as our principal place of residence the following described real property tor
which a Homestead Property Tax Credit is hereby being claimed:
I, (We�owned D�� -�a9�'�- ao
❑ are buying under contract //
❑ have a beneticial interest in the taxpayer �C-�a- -i°O-a°°. 9�o ^Q°�T
Property Description in ���J_=�County ' Township '
Taxing District E6ify, Tewn; Township):
Parcel Number
If buying Ofl contract: Owners name ��ee SimD�¢ ownerl
or�a�� r��n shown �_�� statement �.� —
/ //- .3
�T. ���// - S�-// , O �' 4.u�.
Contract recorded in Recorders Office - Record No. Page
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
;hereby certify the above statement is true, correct and complete.
� ��� � ��� ��� �
Bignature SVeet AaOress Ciry. S;are ana Ziv �e
' Individual either owns or is buying under a contract that provides he is to pay the properry taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residential improv� ents
Other Land � � � �
Total Land .
Residential Improvements ��N �� 197�weliing
� ����.�'�
�
Olher Improvements
bUDiTpp
To'�' Improvemenls - Line (6) plus (7) equals (8)
I�oy certifv�tlie above is true. correct. and complete.
l � , / B i
99^a��e-o1.ASSesw� /
O••
True Cash
Value
(t) SO o
(2) �
(3) S O Q
�4, ia�9a
(5) —
(s>�/�i90
��� �
(8) —,�� � � �
ION BY AUDITOR -
Assessed
Valuation
/70
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-_ -_. .
Homesiead
Valuation
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_ _Date _ .
Date: -�p - Z�—�9