HomeMy WebLinkAboutHomestead_Miller (8)FORM HC 1O 1979 To Be Filed in Oupkate
Prexnbed By Slate Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 -�--
�� /f , SEE BACK FOR FILING INSTRUCTIONS I
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(We) ^'-� /C d
' /certify that on the 1st day of
March, 19 I, (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) ❑ owned
❑ are buying under contract
❑ have a beneficial iglerest in the taxpayer ,r ,
Property Description in—y >✓
Taxing District (City, Town, Township):
Parcel Number
Township
or legal description shown on tax statement:
Q 'S E %-/ /X- ; -S/ . /tea
If buying on contract: Owners name "en simple 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: County Township
hereby certify the above statement is true, correct and complete.
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
True Cash
Value
Land not exceeding 1 (one) acre immediately
surrounding residential improvements (1)
Other Land F I L E u (2)
Total Land Land (3) 66-0
Approved: e•4
77
Assessed Homestead
Valuation Valuation
/70
— 0—
PONJ
ILrNAa
-/,- 5-1-
Date
Date: / "/ 2 _ -i 9