HomeMy WebLinkAboutHomestead_AlbrightFORM HC 10 1979
Remribed By Slate Board of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 -/'?
SEE BACK FOR FILING INSTRUCTIONS D D o
ve) 4'" "`-�'" t certify that on the 1st day of
ch, 19--:2_ I, ( e) 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 in
,(erest in the taxpayer
Property Description
Taxing District (G4y, Town, T0WR6h'p): `/ a
Parcel Number
If buying on contract: Owners name Ilea simple owner)
ty
Township
or legal description shown on tax statement:
Contract recorded in Recorders Office - Record No
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.
03 �
Streel Address
Township
and
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.
Assessed
Valuation
(�o
Homestead
Valuation
9' X979
Dare
Date:
FFIAE SOR'S
USE ONLY -
i
2 1979
True Cash
Value
r
MtP,l
Land not exceeding 1
surrounding residential
(one) acre immediately
improvem is
(1) 90
Other Land
7
(2)
Total Land
AUDITOR
(3) y 9 0
Residential Improvements
Dwelling
(4) 34-4-6—
(5) 9� D
Garage
Total
(6) g
Other Improvements
(7)
-� provements -
l �op
Line (6) plus (7) equals (8)
�
(8)
5y certify the above is true. correct. and complete.
I Signature of Asses r
ACTION BY AUDITOR -
Assessed
Valuation
(�o
Homestead
Valuation
9' X979
Dare
Date: