REAL PROPERTY ASSESSOR'S BOOK
                                                                                                                                          State Form Number 18158  (R2 / 10-01)
                                                                                                                                                DLGF FORM 29
                                                                                                        Authority 6-1.1-5-8
                                              Prescribed by the Department of Local Government Finance
Instructions:
1.  This form is to be certified to the County Auditor on or before July 1.  Computerized transfer of this information or the use of computer generated reports can be used in place of this form.

                                                                                                                                                 Prior Years Assessment                     Current Years Assessment

                                                                                                                                                                                     Assessed
                                                                                                                                          Assessed      Assessed                     Value of Assessed
                Duplicate                                                                                                                 Value of Land Value of                     Land and Value of
                Number    Name of Taxpayer(s) Parcel Number                                                                               and Lots      Improvements           Total Lots     Improvements          Total

                A         B                   C                                                                                                D             E                 F          G        H                I
             1                                                                                                                                                       0.00                                  0.00
             2                                                                                                                                                       0.00                                  0.00
             3                                                                                                                                                       0.00                                  0.00
             4                                                                                                                                                       0.00                                  0.00
             5                                                                                                                                                       0.00                                  0.00
             6                                                                                                                                                       0.00                                  0.00
             7                                                                                                                                                       0.00                                  0.00
             8                                                                                                                                                       0.00                                  0.00
             9                                                                                                                                                       0.00                                  0.00
             10                                                                                                                                                      0.00                                  0.00
             11                                                                                                                                                      0.00                                  0.00
             12                                                                                                                                                      0.00                                  0.00
             13                                                                                                                                                      0.00                                  0.00
             14                                                                                                                                                      0.00                                  0.00
             15                                                                                                                                                      0.00                                  0.00
             16                                                                                                                                                      0.00                                  0.00
             17                                                                                                                                                      0.00                                  0.00
             18                                                                                                                                                      0.00                                  0.00
             19                                                                                                                                                      0.00                                  0.00
             20                                                                                                                                                      0.00                                  0.00
                                              TOTALS                                                                                      0.00          0.00         0.00            0.00     0.00         0.00