Homestead_Corn (2)FORM HC 10 1979 To Be Filed in Duplicate
Prescribed By Stale Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19'7
Credit is hereby being claimed:
I, (We) ❑ owned
O are buying under contract
❑ have a beneficial intergst in the taxpayer
Property Description
Taxing District (City, Town, Township): Uc
Parcel Number
If buying on contract: Owners name llee vmple
Township
or legal
description 'ghown
on tax statement:
94hJ
Land not exceeding 1
surrounding residential
(one) acre imm telil
improvements
E , 0
L(1) �_
jk
Other Land
JUN 5
Contract recorded in Recorders Office - Record
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
r�hereby certify the above statement is true, correct and complete.
4
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 -
Residential Improvements
Other Improvements
•
i
Garage
Total (6)
(7)
Tr' Improvements - Line (6) plus (7) equals (8) (8)
I -�oy certify the above is trgq, correct. and complete.
Signature of Assessor
J
Homestead
Valuation
- ACTION T3Y AUDITOR -
Loi
a /- 7y_
Date
Approved: <J`I Date:
L
True Cash
T Value
Assessed
Valuation
Land not exceeding 1
surrounding residential
(one) acre imm telil
improvements
E , 0
L(1) �_
jk
Other Land
JUN 5
1979 (2) —0—
_ o—
Total Land
i
(3) /'Z SZo
Residential Improvements
Other Improvements
•
i
Garage
Total (6)
(7)
Tr' Improvements - Line (6) plus (7) equals (8) (8)
I -�oy certify the above is trgq, correct. and complete.
Signature of Assessor
J
Homestead
Valuation
- ACTION T3Y AUDITOR -
Loi
a /- 7y_
Date
Approved: <J`I Date: