HomeMy WebLinkAboutHomestead_SwailsFORM HC 10 1879
Prescribed By State Board of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19-2��—
FILING INSTRUCTIONS
0/& -0/070.00
F(We) V' . `L a 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 inter e in the taxpayer
Property Description in
Taxing District (City, Town, Township):
Parcel Number
If buying on contract: Owners name 0- simple pwner)
Township
or legal description shown on tax statement:
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
C
certify the above statement is true, correct and complete.
Street Address Cty. State aid Zip Cote
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 rn
surrounding residentia ts
D
Other Land
Total Land )(IN 211979
True Cash
Value
(1) ff fiTJ
(p) — O
(3)
Assessed
Valuation
X70
Date:
Homestead
Valuation