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FEB -201980 4 <br />RE'FUND APPROVED <br />OR • 462 <br />Revised 12/78 DAT J N 2 #CIC� <br />� <br />(Sec. 195.1 C6, F.S.) <br />r <br />D PARTMEI OF RCVE UE <br />REQUISITION FOR REFUND OF AD VALOI�EN1 TAXIS <br />STATE OF FLORIDA <br />COUNT' OF Indian River <br />Pursuant to Section 195.106, Florida Statutes, <br />Henry Anthony Fischer of P. 0. Box 68,.Sebastian, Fl. <br />(Payee) <br />(Residence) <br />Ilerehy makes application to the Department of Retentie for refund of S 1,950-35 <br />(Amount) <br />of tuonevs paid to the County Tax Collector an(] as grotmds therefor sets tip the folio%iu-; facts: <br />(Slate reason for Refund) <br />The County Property Appraiser has issued a Certificate -of Correction for 1978 <br />Tax Roll, correcting square footage on building which reduces the just and <br />taxable value from $252,450. to $123,350. This reduces the 1978 tax from <br />$3,852.33 to $1,882.28. Dr. Fischer paid the 1978 taxes in Feb.1979, <br />thereby receiving a 100 discount. With the allowance of the 1% discount <br />on corrected amount of tax, the refund comes to $1,950.35. <br />Attached hereto is additional proof to establish such clairtt, as follows: <br />Certified copy of office receipt - taxpayer lost the original. <br />Copy of Certificate of Correction of Tax Roll No. 5- 36030. <br />Sworn and subscribed to <br />before me this /Z day <br />Of . 19 <br />No Publ:c, state of <br />My Cary rnr Florida at Lar^�i <br />sloe Expires APril 1 <br />\otar�•�'uhlic <br />t* <br />V/ � <br />(Pavee) <br />_I <br />