HomeMy WebLinkAboutHomestead_McCordFORM MC 10 1979
Prescribed By Stale Board of Tax Commissioners
To Be Filed in Duplinte
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�� ./
SEE BACK FOR FILING INSTRUCTIONS TI)& 0/6 - DO %-35- 0-D
larch, 19-7-51- I, (We) occupied as our princi paY place 9i"resatlen
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial int restrest i,�payer
Property Description in
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name nee simple owner)
certify that on the list day of
,ing described real property for
Township
I
or legal description shown on tax statement:
dJr Io''A- a1 , Z - /O
or
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
certify the above statement is true, correct and complete.
/a A
Street Address
I //
City. Stale 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.
0
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1 (one) Fe e ate�y - --
surrounding residential imp m ts' ?
Other Land z s
Total Land IUN 0 0979
Residential Improvements Dw lling
AU'b Ivtq
Other Improvements
*T A Improvements - Line (6) plus (1) equals (ti)
t- .,by certify the above is truA correct: and copplete.
Signature of Assessor
True Cash Assessed
Value Valuation
(z) -o-
(3)
(4)
(5)
(6)
(7)
(a)
Ss o
r-- a -
Homestead
Valuation
AUDITOR -
�' -9- 79
Dare
Date: IC — -0 -L�1 /ems% /7