HomeMy WebLinkAboutHomestead_Dougan (4)FOFM HC 10 1979
PresniCeO 9y State BwrG of ia. Commissfoners
io Be FileC in DuDlicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19,7 9 �
SEE BACK FOR FILING INSTRUCTIONS Q�9 - OO�pgy �� �"
r� (We) �/ C��� � certify that on the 1st day of
�vlarch, 19��, I(We) occupied as o r principal place of 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 int rest in the taxpayer .
Property Description in��c.fl-g�.-c� County ��-.� Township
Taxing District (City, T.e�a-�owrtship): ����-K-
Parcel Number
If buying Ofl contract: Owners name ��� simo�e owner�
or legal description shown on tax statement:
O.eGC ��7 / 5 O A/ �
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:
�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 ihe property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
True Cash
� � � � Value
Land not exceeding 1(one, acr imm iatel
surrounding residential improvements (�) �� � � o
Other Land . ,;I�N 2 C� 1979
Total Land
Residential Improvements �,% /
��� � e ling
v AUDITURa9e
Total
Other Improvements
Improvemenis - Line (6) plus (7) equals (8)
by certify the above is true. correct. and complete.
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Approve
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cs� 3 35Go
Assessed
Valuation
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9 yo
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- ACTION BY AUDITOR -
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Homestead
Valuation
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