HomeMy WebLinkAboutHomestead_Glenn (3)FORM HC 10 7979 ia & PileO in Ouplica4
HeStriDeE By Slate Baard af Tm Cammissioners �
CI�AIM FOA HOMESTEAD PROPERTY TAX CAEDIT FOH YEAR 19�
• ..l�I J�J SEE BACK FOR FILING INSTRUCTIONS
l�; �� -
�e) certify that on the 1st day of
erch, 19 I, (We) o upied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed: ��q_p31��a_�
I, (We) ❑ owned
- ❑ are buying under contract
❑ have a beneficial intergst in the taxpayer
Property Description
Taxing District (City, Town, Township):
Parcel Number
If buying Ofl contract: Owners name (�� simo�e owner�
��-�`� Township
or legal description shown on tax statement:
� / �
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 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 resideniial improvemen� � �
Other Land �j �p
Total Land �1.- J6
Residential Improvements �UN I � i979 Dwelling.
age
�� AUDITOR al
Other Improvements
To"' ':nprovements ,- Line (6) plus p) equals (8)
I��y certify the above is true, correc�and complete.
SignaNre of Assessor
True Cash
Value
(�) °Z �'a
(2) �� —
cs� a-8°
(4) -3 0
(5� —D—
cs> g_�3o
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�s> 33 0
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
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Date: � /-�✓ �