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6 <br />Fans AV -10 A "L. <br />(Rey. X90) YEAR g_ ; I J.,.i v <br />APPLICATION FOR PROPERTY TAX EXEMPTION <br />County C f 4 - +a a- <br />Town or City L /9...k: I <br />0" <br />^tL r4,-� <br />/ %.t <br />1 h+�� �r.• <br />r,:� -, <br />Owner ., Gt'r+�rtiM..r( <br />Address <br />A r <br />:- <br />(sueet or Route) <br />(To'vni <br />(State) <br />Mo Code) <br />b••c <br />.` <br />1. <br />Location or Property <br />INSTRUCTIONS . <br />Under the pronaions of G. S. 105 -232.1 a -try awi7r :f ;rc;crry :!aLmiig tlxe,apGdn tar caciuslan from property taxes must <br />demonstrate that the property Meats the statutory regairemenes for exemption or claaatfrcation. Claims for exemption or exelu- <br />sion must be filed with the tax supervisor of the county in which the property is located. (see reyena side) Claims for exemo- <br />uos should include all land and improyaaeats and personal property situated theteon and complete information regarding its use. <br />The undersigned owner or authorized representative hereby petitions for exemption of the following described prop- <br />erty: ILL <br />1 <br />2. Give complete description of property: � �N' L 11L <br />Land: -- jgyit 2 S— g1'- __ ! <br />IAI �`f7�i �fJf7, d111 GGllrece..l <br />f <br />Improvements' '► �+% �, th�f <br />Personal Property: Ah howenr n Jt i (' f 0. <br />3. List andgsplain thq pu oses for wh' thQ prgperty is used: <br />Land. r r+ - 1' l 4 4 Ldt f Xis v r r . <br />Improvements: f <br />Personal Property: <br />4. If any organihtion other than the owner uses the property, give the name of the organization, full particulars <br />regarding its use of tie property and the amount of any income received for such use. NaNC ` .r r.,.. if <br />5" Give your estimate of the true value <br />in monev of the prop�tty_: <br />Land C o By = %1 ec co <br />Improvements a gG'jOa ACM-MID <br />Personal Property: <br />6. List the insurance value of the property: <br />Xx XXX[[Xr XCtXGS [�!'Crtr.r.:::L.S �:LX�� <br />iw f�Wt I cl 11 <br />C tt <br />6. Upon what uses or purposes do you base this claim for exemption? Charitable (' ; Religious ( ); <br />Educational ( ); Literary ( ); Scientific ( ); Other <br />7. Give the spe _ statutory au�,hopty UP w ich this, property i claimed as <br />n1' <br />s — / J d ! r - ••r tin Fy0t rf <br />(Foil texrs or alf exemption and classificalton statutes are available at the of %ice of thi cnunry fax supervisor.) '' <br />— AFFI&MAMOy <br />Under R alnaa preaaibed W law. I hereby affirm that to the best of my itsnwledps and belief, the statements and information in this <br />application are true and correct, and are made for aft purpose of exsmpiuti the prove a+a ed from taastton- <br />S Z 19� L <br />simrrtu[a <br />0+1161' Or 11;1=0=041 repreaeelatfye <br />Vf' <br />- 1�trfjett 3S-7C <br />Title Tele ?none No. <br />r� <br />