HomeMy WebLinkAboutHomestead_RamachFORM HC 10 1979 To Be Filed in Duplicate
Prescribed By State Board at tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR -19 _Z� P« ✓
LL SEE BACK FOR FILING INSTRUCTIONS Orb - 00396-01) x, "S
�(We) e5!l,ett7tiP 1 :e_�,zeL r? a4:n certify that on the 1st day of
arch, 19�, (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
Kare buying under contract
have a beneficial interest in the taxpayer
Property Description in 4: /2 01V County �!��g,�,•�G Township
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners
or legal description shown on tax �statt6rr
Contract recorded in Recorders Office - Record No. 3 Pao e �9- 2�
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
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.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other Land
Total Land {( ar
Residential Imp ovemints L E D
JUL 1 1979
-Other Improves r
T Improvement -Line (6) ppqu
4_ certify the hove is rue. correct.
i 0t Assessor
Approved:— 9,
Dwelling
Garage
Total
its (8)
and complete.
True Cash
Value
(1) / 7c--o
(2) —
- ACTION BY AUDITOR -
Assessed
Valuation
7D
ii •
Homestead
Valuation
,3i 7/
Date
Date: ?