HomeMy WebLinkAboutHomestead_StilwellFORM HC 10 1979
Prescribed By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 -Zf--
SEE BACK FOR FILING I
To Be Filed in Duplicate
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a&- 0/0SC--oD
/(We) __ lk F, IL /t �ify that on the 1st day of
March, 19 -`L, 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 interest in the
X./ . .
Property Description
Township
Taxing District (City, Town, Township): l
Parcel Number or legal description �s%how�n� n tax statement: p ��
.2.
If buying on contract: Owners name (fee simple owner)
Contract recorded in Recorders Office - Record No. Paoe
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 -
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other Land
Total Land
Residential Improvements
WE
Other Improvements 1
T Improvements - Llne (6) plus (7)
I laby certify the Above.4is fr/.4or
Signature of Assessor
True Cash
Value
(1) 6&o
(2) —0 —
(3) 6&0
Assessed Homestead
Valuation Valuation
ez ;Z 0
—0—
.2.2 0
Date
Approved: A� A Date: 6-11 -75