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Ferw AV.t0 <br />(0.av, Lf01 <br />Owner <br />Address <br />YEAR ~i~ ~ ~~ <br />APPLICATION FOR PROPERTY TAX EXEMP~TI\O~N <br />y O-~~~'[dT-- Town oc City ~--xy~-• ~ ~~ <br />(Stan K 0.wu) <br />tTe.n7 <br />4 <br />Y <br />(Zio Gds) <br />1. wls At:rao~ (~a~c~. Z..~.~. • ~9A ~~O.2.1-' a'''']t'Z~3' <br />l.oeaap of Prolsrq _ ~~a `~ • ,~" r_ ~~i~ <br />avszliocrloNS w `~' <br />finder Ora vro+isiens et Q. S. tOS-Ill.l a+ery e•'nn st ~nV~t1- daisies a:asONen a aaslnaien Gem Ore0eRf' tarp star <br />denonatrata tltat the Orovarry mseu Ma aumwrr naeiremanu ter samvtiea er elaaaiReatias. Qaims far aasm-t)en er eaals- <br />tion moat b• Rlad e~iM the ua ae0er+iser at Ms comer is ~hieh the ~rayarer la leeated. (sas ro+ersa aide) Qaims for •saw-. <br />tip ahenld iaalnds all lend and imtrs+oesu aad Peraenal ereNrry' aimstad Msrsw ant aapleta inreesatien ntedint iu sae. <br />Theundersigncdownet or authorized represeatative hereby petitions foc exemption of the following deaaibed prop- <br />erty- <br />2. <br />Persona[ Property: <br />3. List an~esplain toe purposes [or,vrhieh <br />• t. ~ t <br />Improvements: 10 loG ~ tT~t-a-CrC.J4• -- - - <br />Pereensl Drnn~rw D - ~_ Sf <br />~. If any organization other than the owner uses the propcrty, give the name of the organization. luil~pattien[ars <br />regarding its use of the property and the amottat of any income received far each use. <br />5. Give your estimate of the tree value <br />in money th rpp~y:~OQ <br />Land lls~ll77 <br />lmpmtcnencs <br />Personal Property: <br />6. List the insurance value oC the property: <br />xzaxxxzxzxxxxxzxxxxxxzzxzxzxxaxzxzxxxx <br />6. Upon what uses or purposes do ;rou base this claim !or exemption? Charitable ( ): Religions Cd: <br />Educational ( ): Literary (): SeientiCtc ( ); Other <br />7. Give the specific statutory authority upon which this property is claimed ax exempt:~Z,.S. 60J~ ^~?~ •~ <br />(Putt tents o/ art esemptiort aced classification statrctes we avai[abte at the o(fee of the mernry tan supervisor.) <br />AFFiRNAIIO~ i <br />Under oensitiee 9reseribsd br )sue, I Darebr atRrm Mat m Ms Met at mr kas.rledte asd -elisf, the eeaeements and Infsrsatisu i• this <br />a001ieatioa ors tms aed ssmeL aed an made !et the yneoeas of eaemtaeiat Oarrr herein aserl sl hes lon. <br />/ I9 ~ maenre of e~nsr or mw ee rs espun+a <br />919.9 <br />\e. <br />' ~~ <br />i <br />Improvements• <br />