HomeMy WebLinkAboutHomestead_Casey (2)FORM HC 10 1979
Prescribea By State Board at la. Commissioners
To Be Film in Ouplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 2Y J
D,G. (911A %ACK FOR FILING INSTRUCTIONS ID 03 „00 IS'�
is(We) i- u+ a— e-�ti certify that on the 1st day of
vrarch, 19--�t� I, (We) occupied as our principal place of residence the0ollowing described real property for
which a Homestead Property Tax Credit is hereby being claimed:
rte' /3,3 -,Sao
I, (We) owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name
ty Township
or legal description shown on tax statement:
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
hereby certify the above statement is true, correct and complete.
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„ i L R l
I
Other Land
Total Land
Residential Improvements JUN 51979
Dwelljng
r G ag
A915
Other Improvements ,
T -1 I Improvements - Line (6) plus (7) equals (8)
l0by certify the abovos true. correct. arty complete.
S,.iure of Ass .S
True Cash
Value
(1) SB-0
(2) t6 ”
(3)
(4)
(s) —O-
(6)
(7)
(8) 7,30
- ACTION BY AUDITOR -
Assessed
Valuation
/ 70
�`O
Homestead
Valuation
/70
4—If —;7 �?
Date
Approved: Date:69