HomeMy WebLinkAboutHomestead_Whitehead'LPSCCIL')E..'Cl� F3�
CLAIM FOR H(X�'�STEAD PROPERTY TAX CRmIT FOR YFAR 19 S3
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�, �„" , , . _ � �`'`�"��'� � � 'oertify that on the lst day of
N=°cn, 19�, I, (PIe) occapi as our princioal place of residence the follaaing described real
r�=rty for which a Homestead Property Tax Cra3it is hereby being claimgi: 71
I, (i•7e) �aanecl m �.'fup ��g V
� are buyinc? under �ntract �D � � � Z����/ " � � �
� have a beneficial intere„st in the taxpayes
U�
Prorprty Description in �E�`��--
Taxing District (City, Ta-m, 'Ibwnship) :
aounty
�xrnship
U
Pazcel i3im�es or leg descriotion shown on ta�c statanent: .�2
�,� �'.'z �-E '�Y . /3 - '�_-i ° _-7�.
oay-oio �-no
I= buvina on oontract: O�mers name (fee sit�le owner)
Contract recrorded in I��zder's Office - kecord No. _ Page
If any portion of the residential structure or the land, not e�eaiing one (1) acre that
uanediately surroiuris that structure is used to produce incane, describe the use arrl portion of
the property utilized to produce income , � �
� _ �=�-,� _—�
Pny other �wities in which individual owns or is buying real property: Co� 2bwnshio
I h=reny certify the above statanent is true, �rrect and cort�lete.
� � �t;�'Z;�r�.�>�t-�,c_-��,-ri.
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T1dtUi2 ' ' / JLL2eL liO�Tf'SS � . . u�.y � .���.c aau ui�
*Individual either aans or is kuying imer a mntract that pmvides he is to pay the
property.taxes on the residence, or has a beneficial interest in the taxp3yer.
, - FOR ASSESSOR�S USE ONLY -
' True Cash
Value
Larri not exceeding 1;one) acre inunediately
surrourding residential i�rov�nents (1) SB-�
Other Land (2) �
Total Land
?esidential 7nplvv�rnnts
Dwelling
Garaae
c3) �'rJ
(4)
(5)
Assessed
Valuation
J70
.
�������
���������/
Hanestead
Valuation
/ �•O
Total c6) 9 `r� `�9�0
other I�rovanents ( 7 ) �����%/�L!���
� '. Imorov�rents - Line (6) plus (7) equals (8) (8) `� 9 �� /
I heseby c � the is true, correct, anl eo�lete.
n/
<� . � ___ 7�__ Date
- ACTION BY pUDITnR -
Anoro�ed: Date: