HomeMy WebLinkAboutHomestead_Armstrong (3)FORM HC 10 1979
Pum itted By State Board of Tax Commissioners
To Be Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERTN'Th CREDIT FOR YEAR 19
SEE BACK FOR FILING INSTRUCTIONS
O(We) �" �-� �^ `�' Q e O�J 0 certify that on the 1st day of
arch, 19�, I, (We) occupi7 as our principal place of residenc he 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 taxpayer
Property Description in lbll-� County - Township
Taxing District (City, Town, Township):
Parcel Number or legal description shown on tax statement::/
Y -/JEQ4 /o2 -3 -ice
4L.buying on contract: Owners name lfee simple owner)
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
- -4o - tip. 4-1-17- d�;A
Any other counties in which individual owns or is buying real property: County Township
- is - /off`- Doy. 4s0( to
I hereby certify the above statement is true, correct and complete.
Sgnature \ Street Address City, State and Zip Cafe
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 immagiatj '° E D
surrounding residential improvements 1 lint
Other Land MAY 1
Total Land
�A, 0. og
Residential Improvements A 1011 Dwelling
Garage
Total
Other Improvements
T ' ' Improvements - Line (6) plus (7) equals (8)
I �iy certify the above is true. correct. and complete.
Signature of AssessOr
Assessed
Valuation
'02.% C
40o
- ACTION BY AUDITOR -
Date
Date:
Homestead
Valuation
True Cash
Value
(2)
('30
(3)
/430
Assessed
Valuation
'02.% C
40o
- ACTION BY AUDITOR -
Date
Date:
Homestead
Valuation