HomeMy WebLinkAboutHomestead_DuniganFORM HC 10 1979 To Be Filed in Ouplirate
Prmflbed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�� f
p/SEE BACK FOR FILING INSTRUCTIONS 0/(o- O o3o3- oa
tWe) certify that on the 1st day of
rch, 19-- I, (we) occupied as our principal place of residen 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 inter st in the taxpayer
Property Description in aq County Township
Taxing District (City, Town, Township): (J.
Parcel Number
If buying on contract: Owners na
or legal description shown on tax statement:
/EQz7 /
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:
®hereby certify the above statement is true, correct and complete.
D A,
Street Address
County
City,
Township
and Zip
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) acr i ed D
surrounding residential impr%n
Other Land 11
Total Land JUN 1 is 1979
Residential Improvements ��� wel
y; �ling
ge
AUDITOI? otal
Other Improvements
To" Improvements - Line (6) plus (7) equals (8)
1166y certify the above in true. correct, agd complete.
Signature of Asseewr
App
True Cash Assessed
Value Valuation
30 —y —/5/0
(2) 0— —D —
M
Homestead
Valuation
U
/ , . cam% . • � :./
s -a,t2- -*/9
Date
Date: . a-01 —