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HomeMy WebLinkAboutHomestead_Hall (9)PORM NC 10 1979 � P(e5cri0e0 By State Boa�a a� 1a. CommiSSianers io Be FileO in Duo����e CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19� � SEE BACK FOR FILING INSTRUCTIONS D/�� �� ��/, OD ��(We) �`^�—:� �%� � "F �Fy�-{a.��� C• certify that on the 1st day of �arch, 19� �, I, (We) occupied as our principal place of residence the following described real property tor which a Homestead Property Tax Credit is hereby' being claimed: I, (We) ❑ owned ❑ are buying under contract ❑ have a beneficial inteJest, in the taxpayer Property Description .i Taxing District (City, Teiwr,�awnship): 1�./tit Parcel Number If buying on contract: Owners name �'� �'"'P1e °"ne'� ��—a—� Township G or legal description shown on tax statement: C�� � � / .� /.� � '�' L`� Contract recorded in Recorders Office - Record If any portion of the residential structure or the land, not exceeding one (1) acre that immedia[ely 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 �hereby certify the above statement is true, correct and complete. 'Signa�ure Sveet naaress Township Gty. 9ate a'W Li0 �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. Land not exceeding 1�ne�acre� me�el surrounding residential imp vem s Other Land Total Land JUN ? 81979 FOR ASSESSOR'S USE ONLY - Residential Improvement� / ,/j4`k^��Welling v /� � arage �� ��R Total Oiher Improvemenls rovements - Line (6) plus (7) equals (8) certify the above is true. correct. and complete. ol Assessor True Cash Value (1) �/�� O (2) ° �3� y 3 � o (4) �-�—� cs� g3� . v cs�/aLS��'d � - ACTION BY AUDITOR - Assessed Homestead Valuation Valuation - s /jj/�jjjj�j - . ��������� �//�j�j�jj/ /���jj�� /%' ,:;.,' / ��r/j��: �%�f����pj� j//// ��ii/,i�:.,%, '"��/G��O// r ..�� ��Zi . -i ' ��������� .�: i��jj�jjjj •� , c Date: —4� '— /l/ � / �