HomeMy WebLinkAboutHomestead_Taylor (3)FOpM HL 10 1979
PrescriGeO By SWte BoarO o� Taa CommiSSioners
CLAIM FOR HOMESTEAU PROPERTY TAX CREUIT FOR YEAR 19 ��
ia Be FiIW in Duplicate
SEE BACK FOR FILING INSTRUCTIONS �q� ���O A�1
r/o� i�
�(We) ��'`�`-'� ""'�+�"�-�^ �- ���' certify that on the 1st day of v
arch, 19 �� I, (We) occup d as our principal place of resid ce the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
(We) �1 owned �-�.3 �lO ��,�6��o��-do��
❑ are buying under contract
❑ have a beneficial intehest in the taxpayer J �
Property Description
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name �'� "'^o1e °'°^ef�
Township
or Ye�al description shown on tax statement: �/ 3S
C�r �'�y ,�, ��, '�� / 6 - y- � D ��--�—
Contract recorded in Recorders Office - Record No. Page
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
� hereby certify the abo%� statement is true, correct and complete.
� � A i � � . // i . n
�
5tree�
Township
?,u� ,�71P 3 �
Ciry. Scate ana 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 1(one) acre immediately
surrounding residential improvements
Other Land �
Total Land ����
Residential Improvements �Iling
MAR 2 `� { �ara9e
�.
Other Improvements � � � AUD�TdR
To�°' Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct. and complete.
Sig�wre ot nssessor
True Cash
Value
(1) ,:i o0
(z) y' zo
(3) }i o
(a) /a o 30
�5� —
(s) / �0 3a
(�� / 7�30
�g) / 3 'f G o
- ACTION BY AUDITOR -
Assessed
Valuaiion
,•
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Homestead
Valuation
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Gii :;
/!� -=
Date: