HomeMy WebLinkAboutHomestead_Wallace (4)FORM HC 70 1979
Heuri6ed By Sute BaarE ol Ta� Commissioners
To & FiIM in DuD���ate
CLAIM FOfl HOMESTEAD PROPEflTY TAX CREUIT FOfl YEAR 19 ,7�
SEE BACK FOR FILING INSTRUCTIONS
� �/i'a_C,Q_� �� ,�_ -�— ��'�
�(We) y � certify that on the 1st day of
arch, 19�, I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) O owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description i
Taxing District (�ii�c,_Sown, Township): `
Parcel Number
If buying Ofl contract: Owners name ��� simple owne�l
ab� -D� 03 �v
��-�.�� Township
or legal description shown on tax statement:
/ / �CcpR
�� o?Gcl �s� c3'E /y 3 - �- -i o` �
Contract recorded in Recorders Office - Record No. Page
If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property: County Township
;hereby certify the above statement is true, correct and complete.
�Q.�. � vJo�L4c-..._ Q'—'� l:, r, �k�._ � � ,�:.,.��-��,.. �....�
'Signawre Street Aoaress ' ciry, Su:e ane 2ip Cqee
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer..
- FOR ASSESSOR'S USE ONLY -
True Cash
Value
Land not exceeding 1(one) acre immediately
surrounding resitlential improvements (�) Soo
Other Land (2) �"�b
Total Land � � (3) / 3-�
Residential Improvements l � pW�9 (a) I 7 y y c
_ ��n� � y ���9Garage
Total
Other Improvements � �
-T�•-" ' Improvements - Line (6) � "�(7J equa�s�8j"'"�
v i t�rrect. �� lete.
,T�raby certiTy the abo e s ue o cT�ip
�5> -
(6) / � 7 9c
(7) oZ `�o
($) � 8��a
Assessed
Valuation
/ 7 0
�j�jjj��ji,
/O/O%/D/%%/O/i
. = �� �
/ '�
O -� / C/
�d
Homestead
Valuation
/70
�� i9-�°
Dace
Date: _� - �- � - �,�