HomeMy WebLinkAboutHomestead_Church (2)FORM MC 10 1979
Prescribed By Stale Board at Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 —Z`L L.1�
SEE BACK FOR FILING INSTRUCTIONS D// — DO /7s-- 0 D
(We) L-�! -*- E&LA --tl 1 certify that on the 1st day of
I arch, 192`x, I, (We) occupied 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
❑ are buying under contract
❑ have a beneficial ingest in the taxpayer
Property Description
Taxing District (City, Town, Township): C
Parcel Number
If buying on contract: Owners name 'fee simp1e owner)
Township
or legal description shown on tax statement:
i?w g �• 3�z zj� i,
U
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.
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
acre
immediately
surrounding residential
pe)
pr eme
s
Other Land
Total Land
,IUPi a 1979
Residential Improvements Dwelling
arage
� •Dial
Other Improvements AUDI70R
T®r'- Improvements - Line (6) plus (7) equals (8)
,°Oaby certify the above is t correct, and c
Signature of Assessor
Approved
True Cash
Value
(1)
(2) — O —
(3)
(4)
(5)
(6)
(7)
M
Assessed
Valuation
�
� 0 —
!J
Homestead
Valuation
Date
Date: 6 -;' /2