HomeMy WebLinkAboutHomestead_Beadles (2)FORM HC 10 1979
Rescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 2$1
SEE BACK FOR FILING INSTRUCTIONS
To Be Filed in Duplicate
V
003- 0o -03' ""
A(We) � � � V � '179 • 9' 7 �d2�i✓ certify that on the 1st day of
March, 19 Fi I, (We) occupied as our principal place of resid4rice the following described real property for
which a Homestead Property Tax Credit is hereby being �7 claimed,
a� G�C Q J
%
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in County
Taxing District (City, Town, Township):
Township
Parcel Number or legal description shown on tax statement:
S w "/y /iiuJ % 7- .2 - 8 S A
If buying on contract: Owners name (tee simple owner)
Contract recorded in Recorders Office - Record No. Page If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property: County Township
'—hereby certify the above statement is true, correct and complete.
JI n
'Signature
Street Address
City, Statelane Zip Code
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Approved
Assessed Homestead
Valuation Valuation
/70
/7c
3 -z -B
Date
Date:
True Cash
Value
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
(t) So 0
Other Land
(2) Fla o
Total Land
FILED
(3) 7 3a0
Residential Improvements
elling
i9�1"
(4) 20,$,2o
_
Garage
(5)
(6) a20 8j YJ
Other Improvements
X4.0.
AUDITOR
(7) 1-2 4-21 o
Tot -1 -Improvements - Line (6)
plus (7) equals (8)
(s) —Z13 3 L o
I Jy certify the above is
true. correct. and complete.
Signature of Assessor
- ACTION
BY AUDITOR -
Approved
Assessed Homestead
Valuation Valuation
/70
/7c
3 -z -B
Date
Date: