HomeMy WebLinkAboutHomestead_TruittFORM HC 10 1979 To Be Filed in Duplicate
Prescribed By State Board of Tae Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR lg -Z-- J
SEE BACK FOR FILING INSTRUCTIONS
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l(We) `� �� O certify that on the 1st day of
arch, 19 2, I, (We) occupied as our princi I place of residence the following described real property for
which a Homestead Property Tax -Credit is hereby being claimed:
1, (We) ❑ owned ��— ��`�� ��� Grc� • 7 %)" '
❑ are buying under contract
❑ have a beneficial interest i�payer
Property Description in Cou ty Township
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name Ifee simple owner)
or legal description shown on tax statement: 7t/�
Contract recorded in Recorders Office - Record No. Page
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
hereby certify the above statement is true, correct and complete.
/J• . A, . , n n . .,
Address
City. State and Zip Cote
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 immediately
surrounding residential improvements (1) S_0'0
Other Land (2) .910
Total Land (3)
Residential Improvem is Dwell' (4)
j IIR� i 1979_ Garage (s) —o—
/l Total (6) 13060
Other Improvements G,/ /� (7) %� o
!;5 r
T: ®Improvements - met plus (7) eAU (8)
I �r. %by certify the ab e s true.•corre . and complete.
Signature of Assessor
ACTION BY AUDITOR -
Approved
Assessed
Valuation
Homestead
Valuation
-S--If -7�
Dare
Date: