HomeMy WebLinkAboutHomestead_Wheatley (3)FOHM HC 10 1979
Presctibe0 By Slale Boartl nf Tax Commissioners
CLAIM FOR HOMESTEAD PAOPERTY TAX CREDIT FOR YEAR 19��
To Be Filed in DuDlicate
�
SEE BACK FOR FILING INSTRUCTIONS D�9- O3( %�' OQ
��(We) °� W certify that on the 1st day of
�vtarch, 19�`L, I, (We) principal place f residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) I,d%wned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �M� County `�-r-a-�-+-� Township
Taxing District (City, Town, Township): `����+-(<-��
Parcel Number or legal description shown on tax statement:
� s�'�K �-� io
,u.e,.w.. G�iy. vP.t.
If buying Ofl contract: Owners name ��� simoie owner�
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: County Township
�h reby certif the above statement is true, correct and complete.
�35 �� y � \
'Signamre Sneet naaress Ciry. S�are an0 2i Coae
' 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 interest in the taxpayer.
- FOR ASSESSOR'S'USE ONLY -
Land not exceeding 7(one) acre immediately
surrounding residential improvements
Other Land � � � � �
Total Land
Residential Improvements .
!UL `: i919
True Cash
Value
(1) /�30
(2) —
(3) /�f3�
Dwelling (4)
Garage
Ql����u,�2� Total
!�
Olher Improvements � AUDITOR
Tr�-� Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct, and complete.
SigfldtulP �/ ASSPS50!
�s�
(6)
(�)
($)
Assessed
Valuation
�l o
�AD
- ACTION BY AUDITOR -
G-��-75
- Da:e
Date:
Homestead
Valuation
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