HomeMy WebLinkAboutHomestead_TaggartFORM RIC 10 1979
Ptesuioed By State Boatd of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 79'
SEE BACK FOR FILING INSTRUCTIONS 016 —0/077-00
wlarch, 19_- %�._, I, m4f occupied as our principal place of resident
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial interestlerestr in taxpayer
Property Description in 4
&A.- certify that on the 1st day of
following described real property for
i
Township
Taxing District (City, Town, Township):
Parcel Number or leg al description sshoSn�on tax statement:
If buying on contract: Owners name 41.5in1p1e..no,
.p
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
certify the above statement is true, correct and complete.
E
Township
and Zip
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 im fiat
surrounding residentia imrovetents
Other Land
n [
True Cash
Value
(1)
0 7 0 j�iy ".ZSo
Assessed Homestead
Valuation Valuation
(2) —0—
-ZS-0
6—/_7
Date
L
Date: