HomeMy WebLinkAboutHomestead_BeelID 7979
Prep
PreuriEebe d By State Board of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19Z�?
To Be Filed in Buplirate
SEE BACK FOR /FILING INSTRUCTIONS
(We) o- ,, °
place of residence the following described real property for
which a Homestead Property Tax *Credit is hereby being claimed:
I, (We) J9 owned
❑ are buying under contract
❑ have a beneficial injeresj in the taxpayer
Property Description i
Taxing District (City; Town, Township):
Parcel Number
If buying on contract: Owners
owner)
�.h ,za�aci 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
hereby certify the above statement is true, correct and complete
46 1 A
M.
City. State arjJ Zip Cone
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 -
True Cash Assessed
Value Valuation
Land not exceeding 1 (one crepimm4diatel ,
surrounding residential imp merients , (1) 7 0
Other Land
Total Land
Residential Improvements
Other Improvements
UN U 7 1979
�.! ing
AUDITQ .
Improvements - Line (6) plus (7) equals (8)
by certify the above is true. correct. and complete.
of Assessor
(2)
o _ o,_
(3)
(4)
(5) — O
(6) D S.5O
(7)
(8) o�OS`ji�
Date:
V /
7L ,C
Homestead
Valuation
7 9