HomeMy WebLinkAboutHomestead_HadlockFORM nc 10 1979
Prescribed By State Board of Tar Commissioners
To Be Filed in Dupliun,
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19Z�-- A/
SEE BACK FOR FILING INSTRUCTIONS 0/6- 90 y %7- 0
P(We) dA� ;&i.,�.�. 'x �ertify that on the 1st day of
arch, 19_% I, (We) occupied as our principal pl ce of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) P/Owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer _
Property Description in -P "
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name )tee simple owner)
Township
or legal description
shown on
tax
statement:
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.
W— (Z
Streel Address
County
Township
Zip Code
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) acre immediately
currniindinn rpcidpnfiat..imnrnvpmpntc
True Cash
Value
(1 ) / so
rol
Assessed Homestead
Valuation Valuation
a'�..o '140