HomeMy WebLinkAboutHomestead_CaniffFORM HC IO 1979
Prescribed By Slate Board of Tax Commissioners
CLAN91OR
To Be Filed in Duplidate
HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19-23
SEE BACK FOR FILING
� INSTRUCTIONS f0
,�, \to— () 0 is1t-oQ
March, 19_ � I, (We) occupied as our principal place of resident
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ID/owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name ('" Simple owner)
my
certify that on the 1st day of
following described real property for
Township
or legal descYption shown on tax statement:
�a
719 r3& a
1
j�m� Contract recorded in Recorders Office - Record No. Page
�[�4i�J
If al� dential 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
MAR 1 o 1989
individual owns or is buying real property:
hereby certify the above statement is true, correct and complete.
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 -
True Cash
Value
Land not exceeding 1 (one) acre immediately
surrounding residential improvements (1)
Other Land (2)
Total Land (3)
Residential Improvements Dwelling (4)
Garage (5)
Total (6)
Other Improvements (7)
T &!mprovements - Line (6) plus (7) equals (8) (8)
i . by certify the above is true. correct, and complete.
Signature of Assessor
Approved
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
Date
Date: /v J�