HomeMy WebLinkAboutHomestead_MasonFORM HC 10 1979 To Be Filed in Duplicate
Prescribed By Slate Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 '7�'
SEE BACK / FOR FILING INS_TRUC/TIONS 0/4 _ 00 � �/- O o
�(We) � J� A "'_ / '� ' 9'o--O�O� certify thaat on the 1st day of
,,arch, 19 1, (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) Cl owned
❑ are buying under contract
❑ have a beneficial inter t in the taxpayer
Property Description in County Township
Taxing District (City, Town, Township):
Parcel Number or legal description shown on tax statement: esg
If buying on contract: Owners name Too ..Pro owner) 6/7
�� i
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
I hereby certify the above statement is true, 4.2 correct and complete.
aL
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
surrounding residential
improvements
Other Land
Total Land
I L E D
Residential Improvements
Dwelling
JUN ?. 1979
Garage
/ /�tal
,
Other Improvements
?�/
AUDITOR
Tr*ql Improvements -
Line i6)
plus (7) equals (8)
1Seby certify the above
is
true, corRecl. and compNte
Signature of Assessor
ACTION BY
Approved: 1� \ � L �
7a a
True Cash Assessed Homestead
VAIIIP Vahfafinn Valuafinn
(1) S7o
(2) — �-
(3)
(4)
(s)
(6)
(7)
EE
/90
\V
h
.S- a - �7
Date
Date: