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DR . 462 <br />Revised 12/78 <br />(Sec. 195.106, F.S.) <br />C-- r— fit P i -� b r— <br />GATE A.� <br />D tRTME OF`RrVENUE <br />REQUISITION FOR REFUND OF AD VALOREM TAXES <br />STATE OF FLORIDA <br />COUNTY OF <br />Indian River <br />Pursuant to Section 195.106, Florida Statt)tes, <br />Henry Anthony Fischer <br />(Payee) <br />of• P. 0. Box 68, Sebastian, F1. <br />(Residence) <br />Iterel)N makes application to tl)e liepartn)ent of Re%,eniie for rehiiicl of 5 2.137.09 <br />(.\Mount) <br />of n)oneys paid to the County Tax Collector and as grounds therefor sets up the following faits: <br />(:tate reason for Refund) <br />The County Property-Apprai.ser has. issued a Certificate of Correction for 1977 Tax Roll <br />correcting square footage on building which reduces the just and taxable value <br />from $252,450. to $123,350. This reduces the 1977 tax from $4,353.12 to <br />$2,126.99. Dr. Fischer paid the 1977 taxes in Nov. 1977 thereby receiving a <br />4% discount. With the allowance of the 4% discount on corrected amount of <br />tax, the refund comes to $2,137.09. <br />Attached Hereto is additional proof to establish such claini. as follol s:. <br />Photo of original 1977 Tax Receipt <br />Copy of Certificate of Correction of Tax Roll No. 5- 36031 <br />Sworn and subscribed to <br />lwfo4rc n�ie this �_ d•iy <br />of ta^ tit r' 19 <br />Notary public, State <br />My Coof Florida at Large, <br />eission ZxFlres April 1G, <br />1933, <br />�otari P+)l)lic <br />(P N ce) r <br />J <br />