HomeMy WebLinkAboutHomestead_Hughes (9)fOFM HC 10 1979 -
PreuriEea By Sta�e_BwrG ot iaa Cammissfoners
io Be Filetl in DuO���aie
CLAIM FOR HOMESTEAO PROPERTY TAX CREDIT FOR YEAR 19 �9
SEE BACK FOR FILING INSTRUCTIONS
�(We) �"�""%i"�""' —" "`-`-'r�"`-`� certify that on the 1st day of
�„�arch, 19�`� I; We) occupied as our ncipal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed: O I�_�! 1 O 1 �
—1 l�
I, (We) ❑ owned p
❑ are buying under contract �
❑ have a beneficial intereps,t� in the taxpayer
Property Description in �/-�<-�--�- County ��� Township
Taxing District (.City�ewn;-TOwnship): �a-�-�-�
Parcel Number or legal description shown on tax statement:
� �z.o�9,a�
�.E�i� NE /,f /c-z-ii
If buying on contract: Owners name ��� simole o.�e,i
Contract recorded in Recorders Office - Record
Ii 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
' hereby certify the above statement is true, correct and complete.
� � �. _ .
ana Zio Coae
%a
' Individual eithec 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 Homestead
Value Valuation Valuation
Land not exceeding 1(one) acre immediately
surrounding residential improvgem°e�nts �
Other Land � 1 tl �
Total Land � ���8
Residential Improvements ��N 2 U 1979 Dwelling
/ rage
� �i
otal
'{�� AUDITOR
Other Improvements ��
T� Improvements - Line (6) plus (7) equals (8)
A,.aby certify the above is true. correct. and complete.
Sigruwre of Assezsor
Approved
(1)
(2)
S-o 0
3 s�-o
(3) / O �O
(a) SG � o
�5� .2 5�
(g� `a �9 / O
(7) 5�(oc
(g� G � %o
� '7 O
4 0 -�-�a-'
/7 0
�
G-S-7
Daic .
Date: !%' ���—�