HomeMy WebLinkAboutHomestead_BlaizeWRM HC 10 1979
Prescri�ed By Slaie Bw�O ol ia. Cqmmissfoners
io Be Filea in DuD��ca�e
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�
✓
SEE BACK FOR FILING INSTRUCTIONS O(�� OOrqr%-OO
�(We) � �• � �-J�/�"� � • ��-�%certify that on the 1st day of
�vlarch, 19_J�, I, (We) occupied as our principal place f residence the Ilowing 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 ���-��
Taxing District (City, Town, Township):
Parcel Number
If buying Ofl contract: Owners name ��� simple owneq
��J Township
i �. ,
or legal description shown on tax statemeni:
� �. � � ��
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:
�hereby certify the above statement is true, correct and complete.
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 -
Land not exceeding 1(one) acre immediately
surrounding residential improvements . �
Other Land � �j �; � � � �
Total Land �� E$
Residential Improvements _IUN 1 2 1979 Dwelling
Garage
� � �y� a l
Other Improvements � qUDITOR
T� Improvements - Line (6) plus (7) equals (8)
I�oy certify the above is tru� correct. and com�lete
Signatwe of Assessor
���
True Cash
Value
(�) ��
Assessed
Valuation
c5 � b
Homestead
Valuation
330
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- ACTION BY AUDITOR -
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Date: _� � /a�--% /