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DR - 462 <br />Revised 12/78 <br />(Sec. 195.106, F.S.) <br />REFUND APPROVED <br />DATE---NOV 2 7 1 79 <br />PARTME J OF EVEN E <br />REQUISPI'ION FOR REFUND OF AD VALOREM TAXES <br />STATE OF FLORIDA <br />COljNTY OF TnAjn P4va" <br />Pursuant to Section 195.106, Florida Statutes, <br />Crave$ Brne. Cn. of P. 0. Box 277 L. Wabasso. Florida <br />(Payee) (Residenec) <br />I lereby makes application to the Department of Revenue for ret'nnd of S -51 _ 43 <br />(Atuouut) <br />of moues paid to the Count• 'fax Collector and as Grounds therefor sets up the folios%iur; Faris: <br />(Stale reason for Refund) <br />County Property Appraiser reduced the Classified Use Value from $35,500. <br />to $31,990., thereby reducing the amount of the 1978 taxes. <br />Allac•hed he►eto is additional proof to establish :uc h elaiu►. as follmss: <br />Photo of 1978 Tax Receipt validated in the amount of $606.45 <br />Photo of Certificate of Correction of Tax Roll f5- 30755 <br />Sworn and subscribed to <br />before me this ��� dav7q <br />l • /I � � � t�t�!.�11t1' "fir <br />Notary Public• — <br />Noary Fublic, State <br />Cf Florida at Lara• <br />June 6. 1593, <br />:1' <br />GRAVES BROS. CO. , <br />BY:' <br />(PaNee) <br />42 PnE-$ 8 <br />