HomeMy WebLinkAboutHomestead_CampbellFOFlM HC 70 1979
RescriGeG By Sute BoarE o� Tax Commissioncrs
To & Filed in DuO���e
CLAIM FOR HOMESTEAU PAOPEHTY TAX CREDIT FOR YEAR 19�
SEE BACK FOR FILING INSTRUCTIONS
��We) �- �• '�"��M�-�� n-a-�+��- certify that on the 1st day of
�iarch, 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) Q'owned DO�/ ' �OO� 7�
O are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �-�-�'+^� County `�2���.�- Township
Taxing District (City, Town, Township): �4_.�o-G.0 �.n
Parcel Number or legal description shown on tax statement:
.
oE �s��Z /�-2 /a 9. 03,4.
If buying on contract: Owners
Contract recorded in Recorders Office - Record No. Page
If any portion of the residential structure or the la�d, 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
certify the
is true, correct and complete.
Township
, _
Ciry. Scaie ano Zip Coae
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on ihe residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immedi�y
surrounding resident� i�r�em�
Other Land ��
Total Land
Residential Improvements,JU�� 22 �g79
Dwelling
�% Garage
" ' � AUDIT�R Total
Other Improvements
T}' Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct. and complete.
Asxswr
True Cash
Value
(1) /750
(2) / / / o
(3) �29 6 d
ca) ! s/ 7 0
cs� ii v�
�s> /G 3 S �
(�) 'J 3 0
(g) 1 %0 � O
Assessed
Valuation
Homestead
Valuation
�;�
�-�a =�y
Dare _ . -
- ACTION BY AUDITOR -
Date: �