HomeMy WebLinkAboutHomestead_Phillips (5)FORM HC 10 7979 � TO Be FIM in Duplicate
NescriEeO By State BwrO ol Tae Commissioners
CLAIM FOH HOMESTEAD PROPERTY TAX CAEOIT FOR YEAR 19 �9
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SEE BACK FOR FILING INSTRUCTIONS oi9 - o a i��-� o
� fSEOT E. � / r3T.e�C/A / H/LLlGS .
�(We) certify that on the 1st day of
�Aarch, 19�, I, (We) occupied as our 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 interest in the taxpayer -
Property Description in ����Oi� County �To,CA Township
Taxing District (City, Town, Township): ��^�Ce To.�/ �o�F�
Parcel Number or legal desc'r�i tion shown on tax statement:
oulEZ Heic�Ts zs s P,t/� z.3
If buying on contract: Owners name (�� simole
Contract recorded in Recorders Office - Record No. Page
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.
�///_ . 'T �/l%%:iA. �!�//r
County Township
ire She�/ AEareu Giry. Sute an0 Zip �d�� �O
/ / /
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneticial interes[ in the taxpayer.
F � � �'f � - FOR ASSESSOR'S USE
�
MAY 5. i979
Land not exceeding 1(one) acre immediately
su,r�r,� din re ntial ements
O1t�eiS La �
AUDITOR
Total L nd
Residential Improvements Dwelling
Garage
Total
Olher Improvemenls.
T� 'mprovemenls - Li
I ,. ,a� certify the abq
Assessor
(6) plus (7) equals (8)
is true. correct, and complete.
(�)
(2)
(3)
(4)
(5)
(s>
(�)
True Cash Assessed Homestead
Value Valuation Valuation
�iao io�o /o�o
(s) / 3 8�0
- ACTION BY AUDITOR -
s-�-�9
Daie
Date: �— �� !