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MAR = ---b19-80 <br />DR • 462 <br />Revised 12/78 <br />(Sec. 195.106, F.S.) <br />DATc11 0 A I{ � <br />i <br />D RTMEf Or EVEI "UE <br />REQUISITION FOR REFUND OF AD VALOREM TAXES <br />STATE OF FLORIDA <br />COUNTY OI- Indian River <br />Pursnant to Section 195.106, Florida Stat►►tes, <br />Henry Anthony Fischer <br />(Pavee) <br />800K 42 - PAGE m <br />of P. 0. Box 68, Sebastian, F1. <br />(Residence) <br />Ilereh- makes application to the Department of Re%•enne for refund of S 2.137.09 <br />(:�n►nunt) <br />of n►oncN•s paid to the Comity Tax Collector and as grounds therefor sets up the following fasts: <br />(Slate reason for Refund) <br />The County Property Appraiser has issued a Certificate of Correction for 1977 Tax Rc <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 />-� 1 •gas) <br />Attached hereto is additional proof to establish such claim, as follows:- -tip <br />Photo of original 1977 Tax Receipt <br />Copy of Certificate of Correction of Tax Roll No. 5- 36031 <br />';%�orn and subscribed to <br />before me this <br />of zxai 19 <br />Notary public, State of Florida at larEh <br />My Co si„ion EXFire, April <br />16, 1933, <br />\�>tari 1'ul►lic <br />M=5 19 00 <br />-A4� /J/2 <br />