HomeMy WebLinkAboutHomestead_Whitehead (2)FOItM HC 10 1979
Reunbe0 By Slate Boa�d al Ta. Commissioners
CLAIM fOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19��
io Be Filed in Duplicate
�
SEE BACK FOR FILING INSTRUCTIONS A�Q_ �31C;S_ QO
�(We) ��'-�� ���pf�^+ �'���-a� certify that on the 1st day of
sarch, 1�4, 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) 6} owned �[3c��`��ro Fa2�/'� PCR�lT�A� 6tD. 4 �eAi/,
/� are buying under contract
❑ have a beneficial intere.Jst ,'in the taxpayer n
Property Description in �-�d-� Co�u/n�ty '�"�-�� Township
Taxing District (City, Town, Township): `�'��-�+-.� ��-�
Parcel Number or legal description shown on tax statement:
�tYC.�.at. '�cr.uE. i 3 0� .
If buying Ofl contract: Owners name ��� simv�e 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:
�
hereby certify the above statement is true, correct and complete.
; � k/.
County
Township
ana
e �f�570
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 ihe taxpayer. �
- FOR ASSESSOR'S USE ONLY
Land not exceeding 1(one) acre immediately,
surrounding residential improvements � �
Other Land
Total Land � � � � �
Residential Improvements Dwelling
,1UN � 3 1979- �ara9e
� ,,,///��,/�r���� �__�/���_I�otal
Other Improvements , Lr '-�ti
Tr��' Improvements - Line s/6) plus (7) �I�Q�)
I�by certify the above is true. correct. and complete.
Siqnawre
True Cash
Value
( � ) —!_��o
(2) —
(3) /S60
(4) __-J�
cs)
(6) 75� _�
(�l � ,a
(8) 7 O
Assessed
Valuation
,Sa o
�-��-79
Date
Homestead
Valuation
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Date: ��! �