HomeMy WebLinkAboutHomestead_MurrellFORM HC 10 1979
Prescnbed By Stale Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19-1-f-
To Be Filed in Duplicate
I
/ SEE BACK FOR FILING
� INSTRUCTIONS 2
OTIIONS ` 00- t0511 AD0
�(We) �"'- `i" " ' `' "" �"'� certify that on the 1st day of
larch, 19 I, (We) oc pied as our principal place of residence the .following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (we) owned ;7-j &I
❑ are buying under contract
❑ have a beneficial int est in the tax ayer
Property Description in R lxounty Township
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name (fee simple owner)
or legal description shown on tax statement:
91-t I Uj /,/ - "t I)i r'/ / I -.,z -f
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
certify the above statement is true, correct and complete.
'�( -2 660
and
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 immediateL�f 1 2919
surrounding residential improvements N
Other Land
Total Land
Residential Improvements r�$
Garage
Total
Other Improvements
Tr,'-' Improvements - Line (6) plus (7) equals (8)
I0by certify the above is VVe. correct, and complete.
Signature of Assessor
®R
True Cash
Value
(1) 3.�Z O
(2) .D -
(3)
(4) 171o"a -0
(5) —0—
(6)
(7)
(8)
I InfTna _
ti
Assessed Homestead
Valuation Valuation
x5--19- 7 9
Date
Date: ��" 7 7