HomeMy WebLinkAboutHomestead_YockeyFORM XC 10 1979
HeuriDeO By State BoarO oi Tax Commissioners
To & Filed in OuD����e
CLAIM FOR HOMESTEAU PROPERTY TAX CAEDIT FOR YEAA 19�2 �
SEE BACK FOR FILING INSTRUCTIONS 0/Q-03364-p�
�(We)�p •��" �-��- u�-4�� � certify that on the 1st day of
arch, 1y�1?y 1(We) occupied as our principal p ace 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
O have a beneficial inte�r,e,/st �in the taxpayer
Property Description in �cv� County �Q� Township
Taxing District (City, Town, Township): �i�.+�s+-cl�n.- �.r-,a: .Q
Parcel Number or legal description shown on tax statement:
� a(e--E l i �/ii s/i�
---�
If buying on contract Owners name ��� simple �.�e.�
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:
certify the above statement is true, correct and complete.
SUeet AEOress
County Township
,,�,,,�,x . -y%� %O
Ci y. State anC 2i0 �e
' 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 improvements
Otfier Land
Total Land � � �
Residential Improver�nts � Dwelling
��}r.� � 1979 �ara9e
Total
Other Improvements � ���ti��„ piV
piV
T '-'-tmprovements - i e' �`p us (7) �t��8)
I�oy certify the above is true. correct. and compiete.
Asseuoe
True Cash
Value
(1) /J�o
(2) —
(3) / S'a�
(4)
�s�
(6)
(�)
(8)
Assessed
Valuation
�`O
.e�ra'�
�
Homestead
Valuation
1�
- ACTION BY AUDITOR -
S-� 3 -�S
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Approved: ,����--'��� Date: �o— �� %�