HomeMy WebLinkAboutHomestead_LogestanFORM HC 10 1979
Prescribed By State Board of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�� /
SEE BACK FOR FILING INSTRUCTIONS
L.
m03�oo5►S�00
/1&(We) �n • $ ertify that on the 1st day of
March, 19_7 , I, (We) ccupied as our principal plac f esiden the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
(We) 19 owned
❑ are buying under contract
❑ have a beneficial interest i
Property Description
Township
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name llee s'nip'e
or legal description
shown on
tax statement:
p
O 6 b
(4) /9 0
9�w
—O —
i9�70
(6)
(7)
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:
hereby certify the above statement is true, correct and complete.
is
County Township
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 r exeedin� 1 ( a mmedialely
surrou mg esld al ro nts Gy
Other Land tF11
Total Land MKy 2 - 1979 IQ
Residenti Imp ve t/� Dwelling
Garage
AUDITOR Total
Other Improvements
Tr ®-' Improvements - Line (6) plus (7) equals (8)
l0by certify the0aove is true, corrpt. and complete;
True Cash
Value
(1) S-"
(2)
40 0
(3)
p
O 6 b
(4) /9 0
(6)
—O —
i9�70
(6)
(7)
��-
(8)
i9�7o
Assessed
Valuation
l7a
Homestead
Valuation
1-70
Signature of Assessor ��� /I Date
Dater