HomeMy WebLinkAboutHomestead_Warren (3)FORM HC 70 1979
HescriMG By State BaarE of Tax Commissioner5
To & FileO in DuD��te
CLAIM FOR HOMESTEAD PAOPEATY TAX CREOIT FOR YEAB 19 ��
SEE BACK FOR FILING INSTRUCTIONS
,� (We) ��m �" �-° certify that on the 1st day of
Aarch, 19� I, (We) occupied as our principal place residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial interest ,in/ the taxpayer
Property Description in ,/d��+- Cou
Taxing District (City, Town, Township):
Parcel Number
If buying O(1 contract: Owners name ��� simo�e owner)
boG • oa �D
��-� Township
or legal description shown on tax statement:
� Gv'�Z �E'iy ��- 2 -�o �3- os,�)
Contract recorded in Recorders 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: County Township
�
I hereby certif the above statement is true, correct and complete.
� ` ' _�a�t�/ ,P% � �3 : _ �;,.�
'Si aiure Sveet naaress ' ��y, S�aie ana 2iv �e
' 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 -
Land not exceeding 1(one) acre immediately
surrounding residential improJements
Other Land � T � �f T
Total Land 1 .d� �r
Residenlial Improvements
Other Improvements
MAR �'i��
Garage
�1, o.��A C� -
,t�UDITOR
Tntal Improvements - Line (6) plus (7) equals (8)
"�by certify the above is true. correct. and complete.
Signawre oi nssessoe
True Cash
Value
(1) S—D o
(2) �a'
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cs� % 0 30
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($) '�/�3 n
Assessed
Valuation
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- ACTION BY AUDITOR -
Approved: 'Date:
Homestead
Valuation