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i <br />1 <br />.. <br />NpTES IF NEEDED <br />NEW CONSTRUCTION ~p I~~pRnue~ar_~ITO _ _, r <br />Property during the pracE ~~ ~ S~ ~ 2 S , <br />~2-~ aS~~ G~- <br />~r~Q~ U ~ ~- - ~~J <br />ESTILIATEO CONSTRUCTION COST WHE <br />PROPERTY 7AX RELIEF FOR ELDERLY qND P N N I p <br />PERSONS: G.S. 105-277.1 excludes from property taxes the first 20 thousand dollar9 <br />L$20~01 in assessed value of Certain property owned by Ntlrtn Carolina resitlents aged <br />d5 or alder or totally and permanently disabled whose dispgsible income dges not <br />exceed 15 thousand dollars fg750001, The exclusion covers real pproperty or mobile <br />home occupied by the owner es his or her permanent residence. Disposable income <br />includes all money received other than gifts or inhentanCes received tram a Spouse, <br />Ilneal anCe5tdr5, pr Ilneal deCendaOlS. <br />If this application is based upon Igtal and permanent disability, attach a certificate that <br />certilies that you arB totally and permanently disabled from a physi(9an licensed as a <br />medical doctor in Noth Carolina or a govammental agency authonzed to make such <br />determination. <br />APPLLCATION <br />117 Is me property listen an mrs abstract ydru pennanent rasreence? ( ~) ( ) <br />j2)'Nhat is ywrdale al 6~nh? ~~' ~ y YES NO <br />171 did your maposrtxe irwomo Idr 1ha pr ceding colander year ( ~ ( <br />exceed ,l;_ano. <br />VES NO <br />Enter the total disposable income of claimant and spouse for the preceding C711endar year. <br />Clamant 5 ~ Spouse S Total $ r ~~ •_ <br />~~ f r , ~ <br />SIGNEO ~~~'~Y/L-fir ~ 1 ~-~" ~ DATE ~ ~ L,: j r ~ <br />~ S .~ I S :~.~; <br /> <br />GIVE NAME pF LANDOWNER, IF YOU RENT! OR NAME OF MOERE PARK! OR APT <br />NAME <br />ADDRESS <br />CITY/STATE Z1P <br />ADDITIONAL LIS I INV SrACE <br />ITEM MOOEI <br />VE4R MAKE <br />NP ._._ ST'!LE <br />~- ~l T. <br />~. <br />lJC1 ~ C~ <br />VEHICLE 10. NUMBER <br /> <br />- ~ ~~~~, <br />~_~ <br />5 <br />