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Fk .. i+ T- ? s :_, v ±+ r'_ t f- M vn88 v; . ?,..3JrY�r :4:sta....i..4•'-'..
<br /> MAILINGRES$t}, CiZ7rT+LK .} 7.;:.'�_ ,.l) P.O.&7%910 1
<br /> r:rt"G 1�.;.r.zl CHATHAM HAM COUNTY `;:::3_:: ,. %�arnsta zrz
<br /> x,11 IR S' 1517f1 54Z-170[
<br /> Ill MIN FOR LISTING REAL AND P;RsONAt,PROPERTY AS OF JANUARY I AT 100%OF APPRAISED VALUE.
<br /> .Y.,,,,l ;1.,:ut,ii 105 317 1'ruv,d.i.Penativ for Failure to List Pr011er1Y Dwrng rdanit•al January Shall DS 107,or Tao Levi.,
<br /> /PLEASE PRINT AND UbE LEAD PENCIL TO COMPLETE THIS FORM.ENTER A,MDUNT IN DOLLARS C:7LY)
<br /> nu OUT COMPLETELY DH IT mu. BE RETURNED AND DEEMED FILED WHEN RECEIVED BACK INTO OFFICE,
<br /> 4.HOUSEHOLD PERSONAL PROPERTY VALUE 0..c qv
<br /> �'YIF er:lnr.rRn e•4u.MI 6fi AND f,10biLE HOMES
<br /> OUTSIDE tints 10%Or°WELLING VALUE IS S
<br /> CHECK ONE OLOCK ONLY—'--
<br /> ,.,•
<br /> A. ❑ I acct;[[ 10:;of my dwelling vatur,
<br /> I S
<br /> B. ❑ I accept 10 times my monthly rent.
<br /> My monthly rent is S_�_
<br /> ..,_.�
<br /> C. ❑ n c d .u0 n,. •
<br /> Ite rw,ehWU p.w.N pon•elr.u,.r•r.,..,e.,o $
<br /> ,...a t
<br /> Mobile Home Name,.. .Size ' _Yr;, 5
<br /> ,. LESS:Exemption up to $300.00 _ 5
<br /> TOTAL OF ITEM 4 —�15
<br /> ' 5,OTHER PERSONAL PROPERTY
<br /> JTAL VALUE OUTSIDE CITIES .
<br /> Horses,Mules, Ponies_ ,No.__ $.,
<br /> INSIDE CITIES Hogs—_.__No.__.._Pigs No.. Si
<br /> Milk Cows
<br /> Beer Cows& Calves No $
<br /> Poultry_ ., 'No $
<br /> Tractor.Make, _Model, $'
<br /> Tractor.Make Model ' ' S'_
<br /> Harrows E. Plows— ,vim, 5
<br /> Hay Balers 2:i Conditioners «V ,LL S
<br /> Mowers,Rakes& Drills two t 5
<br /> )T AL VALUE INSIDE CITIES Combines or Corn Pickers. v out 5 Mt Irrigation Systems ,w min S
<br /> )TAI VALUE OF ALL REAL ESTATE Silage Cutters & Spreaders vo.. ie 5
<br /> At. ESTATE SOLO SINCE LAST LISTING—TO WHOM AND DESCRIPTION Tobacco Setters&Harvesters v, $
<br /> Milking Machines& Tanks_.., ,v ua 5 ,
<br /> .7.ESTATE PURCHASED SINCE LAST LISTING —FROM WHOM AND DESCRIPTION Dairy Barns,Machinery&Equipment vA.ve 5�_„
<br /> Poultry Houses.Machinery & Equipment__.___. r urur $,
<br /> . Swine Houses.Machinery& Equipment_ _'v:.n $
<br /> JVETeErITS ADDED SINCE LAST LISTING Chain Sows VALLI s.
<br /> } All Other Personal Property $,
<br /> INVENTORY(List at 100% cost as of Last Fiscal Year Ended) READ REVERSE SIDE TOTAL of ITEMS lS
<br /> I 6,VEHICLES
<br /> ..1 5•a.Ended , ,
<br /> INI,„II,c S.ippI,.,_ $, MAKE CYL MODEL& YEAR rrAX DE
<br /> ha...t be IF.,,1hrd Doad,1 s- BODY TYPE
<br /> Auto $
<br /> ..ie Prot.$_ S
<br /> OTAL OF ITEM 2
<br /> IS Auto 5—
<br /> Auto_ _S
<br /> I.MACHINERY,FIXTURES AND EQUIPMENT READ REVERSE SIDE !
<br /> �/,.., Trucks $_•
<br /> cn■nut S Ecvivnmr 3..,_2`!e, I Trucks S
<br /> ;I.;y ER,nPmen,B.Pianos', s 0° Heavy Equipment•LI.r on e.ck Or Asian Listing -.$
<br /> OTAL OF ITEM 3_ $ �� Trailers(Farm or Utility) —Yr. v Ire $
<br /> ROPERTY TAX RELIEF FOR ELDERLY AND PERMANENTLY DISABLED PERSONS: I Scoot.,a
<br /> rAO,orcrde,
<br /> LS. 105^277.1 excludes From property taxes the first seven thousand live hundred
<br /> , Cost $ _Yr,
<br /> _
<br /> chars(57,500)In assessed value of certain property owned by North Carolina residents Airplane _Cost $_Yr. —_„S
<br /> ged 65 or older as of January 1, of year applying or totally and pPermanentty disabled ne.,a roarer
<br /> 'hose disposable income dooa not exceed nine Thousand dollars(S9,000).The exclusion n T'+'N Costs ,Yt,„$
<br /> ewers real property occupied by the owner as Ms or her permanent residence and/or Campers/Motor Homes_Cos[ S_Yr. :$f_
<br /> ousehofd personal properly used by the owner In connection with his or her permanent
<br /> esidence, Disposable Income includes all moneys received other Than gills or !SAC -- Sire
<br /> theritances received from a spouse, lineal ancestors, or lineal descendants. Must TITLE IN NAME OF
<br /> pply for This during the regular listing period, but will be accepted .at anytime -� s
<br /> p to and through April 15 or this year. TOTAL OF ITEM 6.
<br /> ,PPLICATION: PLEASE FILL OUT TILTS AREA COMPLETELY TO RECEIVE EXCLUSION.
<br /> II l; the property listed on this abstract your permanent residence DO NOT WRITE IN THIS SPACE R
<br /> or household personot property used in connection with your permanent TOTAL VALUE OF ALL PERSONAL PROPERTY , S _
<br /> ._—"es,dcnce7 ( ) ( }
<br /> YES NO TOTAL REAL PROPERTY VALUE S
<br /> '.'Ilia[ is your date of birth], • I
<br /> ,Did your disposable income last year,exceed 55.0001 ( 1 ( 1 TOTAL REAL AND PERSONAL PROPERTY S, ' ' C
<br /> :I Enter your disposable income. I YES NO EXEMPTION ,,,`
<br /> ...r..+a •/•I. Tura LESS SCE E7tE!d.TlON
<br /> 1 Ibis application is based upon total and permanent disability, attach a ccrtifi- REAL PERSONAL.. S '
<br /> al,; that certifies that you are totally and permanently disabled from a physician GRAND TOTAL • C,
<br /> tensed as a medical doctor in North Carolina or a governmental agency authorized REAL AND PERSONAL PROPERTY S , [J1
<br /> n make such delurmnation urae.rm.v.e..o.,,..w•+.,..4 In loo.ISon,r•r•.R„,.To s..,,,.r,..,.',,,•
<br /> Dsate.ty Ccrulrcate on Flee, ( ) 1 ) ue„rs.,r„�..y.:ec, ,...., ,.. o ,,m..or i..,,e,..i:..,
<br /> YCS NO •a e..,n,,.• .e,r.•r r,+r,r..+,n�u ... nwp•,,t USr.,.4,,
<br /> !.R,..,r/N.�+!'r.itn to ..NI 1
<br /> r,r:v MO X06:t?s g P[aim. TAXPAYER'S 4 SIGNATURE L.'�'� � .ti"""^�,rt MALC Il
<br /> '',•'•',ca r,v...:,,u5rtn LAST TEAR , DT TAX LIMN . L• T•.S / DAY Cl
<br /> :L-Eci91ONS 1:0' NAME AND ADDRESS TOWNS Pj4 , e TAXPAYER NO YEAR SOC,SEC.NO- '�
<br /> 3r ` i 57a7U/9�/
<br /> G CODE
<br /> ,/ 1 7 r
<br /> BUSINESS S5 i�. J�-+r/r , _ / r+TtSaDao /
<br /> l.. I r r I ,f' V. RFlE DISTRICT
<br />
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