HomeMy WebLinkAboutHomestead_PhillipsFORM HC 10 1979 To Be riled in Duplicate
Prescribed By State Board of tax Commissioners -
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 192
the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) X owned
ire buying under contract= M�n�)�e�z�Q
❑ have a beneficial interest in the taxpayer
Property Description in —
Taxing �.�w� Township
Taxing District (City, Town, Township): (,J(L
Parcel Number or legal description shoA on tax statement:
If buying on contract: Owners
Contract recorded in Recorders Office - Record No. V9499 Page -2150-
p- % %b lto, 3(o93
If any portion of the residential structure or the land, not exceeding one (1) acre that immediate y 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
and
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 reside rt Other Land E
Total Land
Residential ImprovemeniOL 31979
Dwelling
Garage
-
rl— /'
Total
// AUDITOR
Other Improvements
Tyr l Improvements - Line (6) plus (7) equals
(8)
I by certify the above is true correct. and
clopplete.
Sgna,.,e of Assessd,
True Cash
Value
M-46-0
(2)��1/b
(3)
(4 )
(5)
(6)
(7)
(8)
- ACTION BTI AUDITOR -
Assessed
Valuatinn
/5'a
—O—
Homestead
Valuatinn
/So
%0%0.0.00.00,0%
bare -
Date: _��