HomeMy WebLinkAboutHomestead_RichesonFORM HC 10 1979
Prescribed By State Board of lax Commissioners
In Be fit" in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 191
SEE BACK FOR FILING INSTRUCTIONS 0/to _00A7 O•D
(We) °-"''"-e-aJ 69"', certify that on the 1st day of
arch, 19-7.9— I, (We) occupied as ur principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
(We) ❑ owned
❑ are buying under contract
❑ have a beneficial interest in the to
�lil e,
Property Description
Township
Taxing District (City, Town, Township):
Parcel Number or legal description shown on taxi statement:
If buying on contract: Owners name 1Q-
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: County Township
certify the above statement is true, correct and complete.
Street Addrem
and Zip 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.
Land not exceeding 1 (onird
surrounding residential im ve en
Other Land
Total Land
Residential Improvements �,
Other Improvements
- FOR ASSESSOR'S USE ONLY -
welling
rage
AUDITOR Total.
Tr••-' Improvements - Line (6) plus (7) equals (8)
-0-by certify the above is true. coAect. and c
Signature of Assessor
True Cash Assessed- Homestead
Value Valuation Valuation
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