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Rr-MND APPROVED <br />DR . 452DAT~ J N 2 4 1990 <br />Revised 12/78 ` <br />(Sec. 195.1 C5, F.S.) // /I <br />DbPAR T i\ E OF%REVE" UE <br />REQUISITION FOR REFUND OF AD VALt)IJE`l T,%xi.,S <br />STATF: OF FLORIDA <br />COUNTY OF Indian River <br />Pursuant to Section 195.106, Florida Stattites, <br />Henry Anthony Fischer of P. 0. Box 68, Sebastian, Fl. <br />(Payee) (Residence) <br />Ilerebv makes application to the Department of Revenue for refund ()I'S 1,950.35 <br />(Amount) <br />of moneys paid to the County Tax Collector and as grounds therefor sets tip the follohing f;icts: <br />(State reason for Refund) <br />The County Property Appraiser has issued a Certificate of t6eF861id'n 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 1N discount. With the allowance of the 1% discount <br />on corrected amount of tax, the refund comes to $1,950.35. <br />Allached hereto is additional proof to establish stick claim, :is 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 nie this .1Z_ day <br />of_bn!. ,19� <br />NOt3►Y Public, Mate of <br />My Com Florida at Lar^4i <br />sion Expi►es APri►� <br />Notary tiblic <br />r <br />MAR .5.1980, <br />'. 'BOOK 42, FADE 894 <br />