HomeMy WebLinkAboutHomestead_McDonald (2)FORM HC 10 1979 to Be Filed in Duplicate
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19-17--
SEE BACK FOR FILING INSTRUCTIONS 0/&— 009,36- CZ
`IR (We) .f° certify that on the 1st day of
R e 19� I, (We) occupied as our66rincipai 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 intejoSt in the
r
Property Description in County _ _ � Township
Taxing District (City, Town, Township)
Parcel Number or legal description sho n on tax statement:
'W. Ery - -)- If buying on contract: Owners name (fen simple owner)
Contract recorded in Recorders Office - Record
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:
. t hereby certify the above statement is true, correct and complete.
County Township
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.
6C0
- FOR ASSESSOR'S USE ONLY -
True Gas_ h Assessed Homestead
Value Valuation Valuation
Land not exceeding 1 (one) acre immediately
surrounding residential im�t�
Other Land q�9
Total Land
Residential Improvements JUN 261979
Dwelling
� Garage
!/
AUDITOR ITOR oral
Other Improvements
I i' Improvements'- Line (6) plus (7) equals (8)
by certify the above i true. correct. axl complete.
Y
Signature of Assessor
I
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
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Dare _
Date: