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<br /> Sial. Property T811 Soerd <br /> Tax R.lund Applicallon 31.11(4/82) APPLICATION FOR TAX REFUNo(f'rQ}<tt c;.J.., "1110) <br /> Collecting Office Name: tJ; tr t' f s ~ Iv? It. ý' (!A:) ~ <br /> Collecting Tax For: <br /> (Taxing Units) <br /> Address <br /> City, State. Zip Code <br /> ----------------------------------------------------------- <br /> In order to apply for a tax refund, the following information must be provided by the taxpayer. <br /> IDENTIFICATION OF PROPERTY OWNER: <br /> Name: I t'e:$.' <br /> Address: <br /> Telephone Number (if additional information is needed): n~ <br /> IDENTIFICATION OF PROPERTY: <br /> Description of Property: If. ~ Jk. :J/YJ. ¡)~~~ 17";¿ <br /> <br /> Address or Location of Prope <br /> Account Number of Property: <br /> INFORMATION ON PAYMENT OF TAXES: <br /> Name of Taxing Unit Year for Amount of Tax <br /> From Which Refund Which Refund Date of the Amount of Tax Refund <br /> Is Requested Is Requested Tax Payment Taxes Paid Requested <br /> 1. O;~""">'/YJ 19 1'~ ¡.:J / 1911:, $ ~Z¡o6:.fz. $ 1:(.,. 7:S"~ ,5'0 <br /> - <br /> 2. 19 /19- $ $ <br /> 3. 19 /19- $ $ <br /> Taxpayer's reaso~ for refund !attach s,,':f~ documentation): (1/~~~ ~d¡7/a..,~~ <br /> ~ 'fi? .?6'.;t;. ~c.? ~IO. /.yi:,4/llo a-...:Il ~çÎ,.f' ~cvtI<- .~4A.~ ew....t-46..57, ¿c..O <br /> ..A,e.~ U-.-'¡;;I. 9Po. 700. da..{ ~¿? A $/6:(;.:)'3.3.2.... H~£a.-..-t ~.fï~ <br /> tf ~ï'!J.,J'7:J'),.6"'o ,Ù.. ~~~(;:I ~ A.~I-~~..f, 5,~ (?~trf~~ &,t?4. JU- ;2¿.ltJ; <br /> "I hereby apply for the refund of the abov&<lescribed taxes and certi1y that the information I have given on this form <br /> is true and correct" <br /> .:; ~-e d~.:tt!::.. ~c -¡/~cf. 2. - -;..7-;'(, <br /> Signature Date of Application for Tax Refund <br /> ----------------------------------------------------------- <br /> Disapproval <br /> ~'.¡6 <br /> Date <br /> Emmie Craddock Ma or 3-25-86 <br /> Signature of Presiding Officer(s) of Taxing Date <br /> Unit(s) for relund applications over $500 <br /> Any person who makes a lall. entry upon Ihe foregoing record shall b. subject to on. ot the following penal tiel; 1. ImprIsonment ot <br /> not more than 10 years nor less than 2 y.ars and/or a fine of not more than $5,000 or bofh such line and <br /> imprisonment; 2. confinement In lailtor a term up to 1 year or a line nol to exceed $2,000 or both luch fine and Imprllonment as let <br /> forth in Section 37.10. Penal Code. <br /> REFUND: 31.11 <br />