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Homestead_Clark (2)FORM HC 10 1979 Prescrioed By State Board of Tax Commissioners CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19- o ©s _C'a I 1 To Be Film in Duplicate SEE BACK FOR FILING INSTRUCTIONS JR(We)�r { certify that on the 1st day of I arch, 1921?— I, (We) our principal pladVof residence the following described real property for which a Homestead Property Tax Credit is hereby being /claimed: I (We) ownedCO-��/ EVI are buying under contract ❑ have a beneficial , gtere�t in the taxpayer Property Description Taxing District ECiRy —Tow"; Township): Parcel Number If buying on contract: Owners name uee simple Township or legal description shown on tax statement: ?� Sz s< /7 -.2-// 7,4--0 Contract recorded in Recorders Office - Record 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. 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. - FOR ASSESSOR'S USE ONLY - Approved Assessed Homestead Valuation Valuation -7 -7 Dade Date: rp�� True Cash Value Land not exceeding 1 (one) acre immediately surrounding residential improvements _ (1) oa Other Land F I L E Total Land W (3) /0 '70 Residential Improvements , _,,, �y 2 1 gig Dwellin a 7 a-a-,:5> () / / Garage (5) iSl (6) // 7 0--o Other Improvements r (7) / 90 T-' 'Improvements -Line AUDITOR (6 plus (7) equals (13) (a) 9 by certify the above is true. correct, and complete. s' nat a of assessor — - - ACTION BY AUDITOR - Approved Assessed Homestead Valuation Valuation -7 -7 Dade Date: rp��