HomeMy WebLinkAboutHomestead_CarterFOflM HC IO 1979
Prescri�eA By Siate BozrG of Tax Commis5ioners
ia Be FileG In WOlicate
CLAIM FOR NOMESTEAU PROPERTY TAX CREUIT FOR YEAR 192`L /
SEE BACK FOR FILING INSTRUCTIONS Q�L� _ 0 p3 ��� 00
�(We) ��� •�"� � certify that on the 1st day of
�vlarch, 19�, I, (We) occupied as our principa place f 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 inte,�est in the taxpayer
Property Description
�U-'�'�—�--% Township
Taxing District (City, Town, Township): \'1 n--�--✓�-�-�-�"+�-/
Parcel Number or legal description shown on tax statement:
, . Q.�C� �a-.:�
If buying on contract: Owners name �'� "'"o'e °""e`�
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:
� herpeby ceriify the above statement is true, correct and complete.
�.,ir.�ia,.��� ` � .. , _ _ �
s�,��
County Township
Cny. Sta�e ana 2io �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 im�v�e� � �
Other Land
Total Land
Residential Improvements ,;�J:,' 9.; 19�g Dw�ng
(/� �����u12�age
AUDITOR al
Other Improvements
T�'-� Improvements - Line (6) plus (7) equals (8)
i�aby certify the above is trpe. correct. and�omplete
Signa:ure ol Ass¢Swr
G
True Cash Assessed Homestead
Value . Valuation Valuation
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(2) —6— — o —
(3) //�O ���
(4) �O
�5� 70�0
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3�0
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