HomeMy WebLinkAboutHomestead_Riddle (3)FORM HC 10 1979
Presented By State Board of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 192E J
SEE BACK FOR FILING INSTRUCTIONS
�— 003- 40 011 1k - o'Z
(We) . L fr 9�p — certify that on the 1st day of
'larch, 19--7-7— I, ( e) occupied as our principal plat of residence the following described real property for
which a Homestead Property Tax Credit is hereby C ) being claimed: 1 n
I, (We) ❑ owned O— /�/ %—.6e'!j
❑ are buying under contract
❑ have a beneficial intgrest in the taxpayer
Property Description i
Taxing District (City, Town, Township): t�
Parcel Number
If buying on contract: Owners name Ilee simple owner)
Township
or legal description
shown
on tax
statement:
� . c/17W i/y
t 9
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.
Signature Sweet
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 not exceeding 1 (one) acre immediately
surrounding residential improvements
Other Land
Total Land E Le Residential ImproveEts I Dwelling
t;li,1131979 Garage
Total
Other Improvements
Ti "' Improvements Lin j plus (7)Aa 1 (8)
I,by certify the abo true. correct. end complete.
Signature of Assessor
True Cash
Value
(2) - O
(3) 9.;� 0
(a) —3 750
(5) —p'
(s) .3 7.�o
(7)
(g)
- ACTION BY AUDITOR -
Assessed
Valuation
- /70
Homestead
Valuation
Daze
Approved: le6ss�g� Date: