HomeMy WebLinkAboutHomestead_Wallace (5)fOPM HC 10 1979
Presc�iGeC By S�ate Baa�G al Ta+ Commissfoners
To Be FileO in Duo�icate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�`�
SEE BACK FOR FILING INSTRUCTIONS
�(We) �%!��-Q ��,/ °�" certify that on the 1st day of
Sarch, 19� I, (We) occupied our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby�being claimed:
I, (We) J�owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Descriptian
Taxing District (6iiy� Fawrt, Township): `�
Parcel Number
If buying on contract: Owners name �'� �""o1e °^"ef�
oo�- o ao.�.�
unty �w`--d--��^- Township
or legal description shown on tax statement:
�o� � LtJ ��f- �-z -/� (°`7' � 8%%>
Contract recorded in Fecorders Office - Record
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:
A hereby certify the above statement is true, correct and complete.
1,
County Township
' 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 �{nne acr �imme '�tel
surrounding residential imp�ove�ts �� (�l .� O O
Other Land (�) � �'—
Total Land ��� % � 19i�_ (3) /�-��
Residential Improvem�gn/t� /����� Dwelling
!� ' � Garage
AUDITOR Total
Other Improvements
T/�'�' Improvements - Line (6) plus (7) equals (8)
I`��by ceriify ihe above is true. correct. and complete.
Signa:ure ol nssessor
(4) � 3 3a�
(5) —
�s� a 3 3 0 0
(7) �l�3n
�s� � 8 7 3 0
Assessed
Valuation
/ %o
�
!
Homestead
Valuation
/ 7 c�
�— i9-79
Da:e
- ACTION BY AUDITOR -
Date: _� l7�