HomeMy WebLinkAboutHomestead_BammerweM Hc io i9n
Hescribe0 By State BaaN af Tax Commiuioners
To & FiIM in DuD���te
CLAIM FOR HOMESTEAD PROPERTY TAX CAEDIT FOA YEAR 19-22
SEE BACK FOR FILING INSTRUCTIONS .
�(We) �/1'n.[ al �� �F Z certify that on the 1st day of
rvlarch, 19�Y, 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) C�'owned oo�' �����Q�
❑ are buying under contract
❑ have a beneficial inte�re-/st �in� the taxpayer �
Property Description in�d�E_n� County `P�� Township
Taxing District (City, Town, Township): ��-a- u-l�c�
Parcel Number or legal description shown on tax statement:
PE 5 w�i� � P-/-i� ! T�-.
If buying on contract: Owners name �'� $nip1e °'^'"ef�
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:
hereby certify the above statement is true, correct and complete.
�•�.�
SVret AOO�e55
County
Ciry.
Township
y�G6G
ana Zip COGe
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 -
True Cash
Value
Land not exceeding 1(one) 333���111 i� iate�
surrounding residential impro�en (�) �
Other Lantl (2) �
Total Land
Residential Improvements
,IUN � �91g
�. i A�
�
Total
Other Improvements
Tr�-� Improvements - Line (6) plus (7) equais (8)
I��by certify the above is true. correct. and complete.
AS52550�
(s) Soo
(4) (0490
(5) �-
(6) (0 990
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- ACTION BY AUDITOR -
Assessed
Valuation
/ 70
Homestead
Valuation
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5-.�-`f-7S
Date
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Approved: (/� - `1 • � , -« /-��2.c� Date: � ;�' �,�_