HomeMy WebLinkAboutHomestead_HouchinsFORM HC 10 1979 To Be Filed in Duplicate
Preuribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 'If
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SEE BACK FOR FILING INSTRUCTIONS. /6_9osys -ca
–Qft(We)
� (9, 5- / /[Qit.�r 6 - ertify that on the 1st day of
arch, 19-4-1 I, (We) occupied as our princip9l 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 interest in the
Property Description
Taxing District (City, Town, Township): C/
Parcel Number
If buying on contract: Owners name (fee simple owner)
Township
or l /e�Jgal (j ^
djesscriipttion sh(Ywn 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: County Township
hereby certify the above statement is true, correct and complete.
Street Address City. State and 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 -
not exceeding 1 (one) acre immediately
Inding residential i�ro e
Land `F 0
Land
ential ImprovementsUl 3 i979
a�—�
Improvements /
K
AUDITOR
True Cash
Value
(2)
(3)
Dwelling (4)
Garage (5)
Total (6)
(7)
rovements - Line (6) plus (7) equals (8) (8)
certify the above is true,Aorrect. and corpj)lete.
of Assessdr
Approved
Assessed
Valuation
/70
—O— —D-
Homestead
Valuation
Ar.Tlr1N RV Al IhITr1R -
Date:
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