HomeMy WebLinkAboutHomestead_DyeFORM HC 10 1979 -
Presrribed By State Board of lax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 77
To Be Filed in Duplicate
J
SEE BACK FOR FILING INSTRUCTIONS 1001- Doa13 -0Q
OD(We) � �- � ��L "+ ) &-N, certify that Jon the 1st day of
March, 19 I, (We) occupied as our principal plalz'e of residen& the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract �7Co
❑ have a beneficial ir4prest in the taxpayer
Property Description in County �- -- �.,`.� Township
e i
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name 'lee
or legal description shown on tax statement:
-t . jf% /3 —a— 9 /r?- .2ya" —I %
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
hereby certify the above statement is true, correct and complete.
Address
Township
?CG,n
City. State and Zip Cone
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 -
True Cash
Value
Land not exceeding 1 (one) acre imme I
surrounding residential i v efts_ (1) �0-O
Other Land � L 1 (2)
Total Land MAY 21 1979 (3) 02 7.2 0
Residential Improvements�j //� �/ // t /�/ //�,D.,welling (4)
�► •r+ ZU�c.Qd�tv�t9rage
(5) vOr
r/ AUDITOR Total (6) .3�s90
Other Improvements (7) / X60
'� mprovements - Line (6) plus (7) equals (8) (8) �T"�.SO
I }hereby certify the ab a is true. corr ct. and complete.
Signature of Assessor
10 lr ACTION BY AUDITOR_:
Assessed Homestead
Valuation Valuation
10
-- 9-1-07380
S - - &— 79
Dane
Date: