HomeMy WebLinkAboutHomestead_Angle (3)�- FONM HC 1� 1979 f io Be Rlea in WDii�ate
Prescri�e0 By S�a�e Bw�a ol ia. Commissloners ,
CLAIM FOR HOMESTEAU PROPERTY ,T{IX CREUIT FOR YEAR 19 ��
SEE BACK FOR FILING INSTRUCTIONS
_� (We) l���� �� �--� � certify that on the 1st day of
larch, 19 I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buyin9 under contract
❑ have a beneficia/l i�nterest in the taxpayer
Property Description in v"'.�-�-�-�-� ^
Taxing District {6i�y-Tawrt, Township): `� a
Parcel Number
If buying on contract: Owners
aw�e,i
0 01�-�00`�'��b0
�i�-� Township
or legal description ShOwn on tax Statement:
�.�- �P. �. % �tl �. %� .3 v - a - i o • 9G �c.
Contract recorded in Recorders Office - Record
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 oi the property utilized to produce income
Any other counties in which individual owns or is buying real property:
I hereby certify the above statement is true, correct and complete.
� .,�-- ,✓,A %�s,�� � Y� �i �.�;�,-o
County Township
Gry. State antl Zip CoEe
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 MAR ].8 �$�Iling
�, �. rage
Other Improvements
AUDITOR
Total Improvements - Line (6) plus (7) equals (8)
�.by certify the above is true. correct. and complete.
A55¢s50e
True Cash
Value
(�) S o 0
(2) - ° '
(3) S � o
(a) � !0 30
(5) CG-��-�
(s) G G 3 0
(7� - e —
(8) � G 3 D
- ACTION BY AUDITOR -
Assessed
Valuation
/70
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Homestead
Valuation
Date
Date: