HomeMy WebLinkAboutHomestead_NeyhouseFORM HC 10 1979
Prescribed By State Board of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19-2L J
SEE BACK FOR FILING INSTRUCTIONS 00 o
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Vtfof-1owcing that on the 1st day of
parch, 19 I, (We) occupied as our princip place of residenc described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are. buying under contract
❑ have a beneficial interest in the
Property Description
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Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners na
a2' /.3 -d - /ao - cam. �/9-
my �a Township
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or legal description shown on tax statement:
(2t Elul%
Contract recorded in Recorders Office - Record No
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.
County Township
ns or is buying under a contract that provides he is to pay the property taxe!
the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1
(one) acre immediately
swounding residential
iiOrov�mentL
Other Land
Total Land
Residential Improvements :! JN
41
Other Improvements
71979
Dwelling
ar g
Total
AUDITOR
r ® -' Improvements - Line (6) plus (7) equals (8)
W. by certify the above yak true. correct. end complete.
Signature of Assessor
True Cash
. Value
(2) 1a �-/O
(3) S' %5ZO
(4) !o O
(5) — O —
(6)
(7) /-F arf O
(8) J„2S".SO
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Assessed Homestead
Valuation Valuation
Date
Date: 6 1 Z // /