HomeMy WebLinkAboutHomestead_Williams (23)FORM MC 10 1979
PrexriEea By State Boara ol iax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 79
To Be filea in Wplicate
�
- SEE BACK FOR FILING INSTRUCTIONS ��q_�3a�4_oo
��(We) �°'��- � ��-�� �• ��-y^-� certify that on the 1st day of
� arch, 1�`�, I, (We) occupied as o r principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We)�wned
❑ are buying under contract
❑ have a beneficial interes in the taxpayer
Property Description in
Taxing District (City, Town, Township):
Parcei Number
If buying on contract: Owners name �'� ��mwe owneq
Township
or legal description shown on tax statement: �
C�,u.a.4,.x..�..� CI� a/�.t 3 P�
Contract recorded in Recorders Office - Record No
If any poriion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
s[ructure is used to produce income, describe the use and portion oi 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.
County
Township
�
Assessed Homesiead
Valuation Valuation
6go
� S" o
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` 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.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residential improY'emen"� � �
Other Land d
Total Land
����� � 5 1979.
Residential Improvements Dwelling
�% �arage
r�� � Total
AUDITOR
Other Improvements
T'�' Improvements - Line (6) plus (7) equals (8)
F�by certify the above �true. correct. and complete.
_ .
Approved:
True Cash
Value
(7) 2ozo
(2) �
(3) 2ozo
(4) /.�SBo
(5) �(6) �S �Po
(7) �1
�g� /S, SPo
- ACTION BY AUDITOR -
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,.�2. / 9 7 9
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Date: (IL��%�