HomeMy WebLinkAboutHomestead_Carpenter (3)FORM HC 18 195
Prewioed By State Board a: Tax Commissioners
To Be riled in Bupticale
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 Z 0013�
SEE BACK FOR FILING INSTRUCTIONS
(We)
;G
March, 19 I, (We) occu 1 as our princi
which a Homestead Property ax Credit is he
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial interest yn the taxpayer
Z certify that on the 1st day of
ce of residence the following described real property for
being claimed:
ae- 1719_15
Property Description in County _� y Township
Taxing District (rk ,, Town, Township):
Parcel Number or legal des ription shown on tax statement:
Vii—
If buying on contract: Owners name 1tee simple owner)
Contract recorded in Recorders Office - Record No. Paqe
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
46he//r��eby certify
�
e��rtifythe h above sttaatteement is true,, correct and complete.
(
y;;�g 6s
and Zip Code
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) acrL imjdiv
D
surrounding residential
improvements
Other Land MAY 16 1979
Total Land
Residential Improvements f Dwelli
Total
Other Improvements
Improvements - Line (6) plus (7) equals (8)
by certify the above is true. correct. and complete.
n.
Assessor
True Cash Assessed Homestead
Value Valuation Valuation
(2) a `%
(3) 7 910
(7)
J.MUM
r
- ACTION BY AUDITOR -
J7o
bo
.S`- 7
Dale
Approved: 0 9.� Date: '5_Z6 -