HomeMy WebLinkAboutHomestead_Byrns (2)POftM HC 10 1979
NescriCeG By State Boara ot ia� Cammissfoners
ia Be File� in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 �?9 �
SEE BACK FOR FILING INSTRUCTIONS 0�9_ D a�j g�� O O
�(We) �""�-.QQ- �> ���� certify that on the 1st day of
. arch, 19— �'�, I, (We) occupied as our pri ipal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) Q'owned
❑ are buying under contract
❑ have a beneficial inte,,r/est� in� ihe taxpayer
Property Description in .�LJti.(�d-o�.,> County �a�� Township
Taxing District (City, Town, Township): �/Lcix-c.c�trv.� c.c�xin.c�f�- �
Parcel Number or legal description shown on tax statement: -
'I7 ��18
If buying Ofl contract Owners name ��� s�moie owneq
Contract recorded in Recorders Office - Record N
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 certify the
� /i A
is true, correct and complete
' 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 Assessed
� Value Valuation
Land not exceeding 1(one) acre �me�ately�
surrounding residential improvements (�) ld�o 3Go
Other Land
Total Land
Residential Improvements
;��r� �i 1979_ �2�
.. .
/� r ... , � _ . .
� : .i; � - �
Total �6>
Other Impravements
T�� � Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct. and complete.
ol Assessar
(�)
�
- ACTION BY AUDITOR -
3�0 0
Homestead
Valuation
�-�3-�9R � ,
oa��
Approved: � • � t// /—n Date: ��-� 9