HomeMy WebLinkAboutHomestead_McGregorFORM HC 10 1979
Prestrioed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19`1
To Be Filed in Duplicate
SEE BACK FOR FILING INSTRUCTIONS D/&- O D r7y P- o-p
(We) � �'��'e" certify that on the 1st day of
.larch, 19 /9 I, (We) occupied as our principal nla_e 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 inter st in the taxpayer
Property Description in /
Taxing District (City, Town, Township): t-
Parcel Number
V
my
Township
or legal description shown on tax statement:
J.
If buying on contract: Owners name "e� s'm0'e owner)
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.
County
Township
0
I
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
surrounding residential improvements -
Other Land
Total Land
Residential ImWojveentsL
JUP? 1 81,979
Other Improvement
,
Teel_ Improverrt- pe
10by certify the ave is
Sgna:ure of ASS sor
Dwelling
Garage
Total
True Cash Assessed
Value Valuation
(2) —O-
(3)o-o
(a) SO
(5) O
(6) 6 0
��
als (8) (a)
and gomplete.
Homestead
Valuatinn
Owe
Approved: i )'°° °°"`Ctt Date: (1. 0-