Homestead_Higginbotham (6)FONM HC 10 7979 � To & FiIW in MD�iwte
Reuri�e0 By State BwrO af Ta. tommiuioners
CLAIM FOR HOMESTEAD PROPEATY TAX CREUIT FOR YEAR 19 7 9
SEE BACK FOR FILING INSTRUCTIONS �5����
�(We) � -^- � = � - � /���—��-�-��� --���'�°�ify that on the 1st day of
March, 19ZL, I, (We) occupied as our principal place of r�sidence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed: �
I, (We) ❑ owned ��' �7 Q'j`= / au - ��• Oc7C� - �°�/
❑ are buying under contract
❑ have a beneficial inj,eyest i� the taxpayer
Property Description
Taxing District (GiFy,�oa�iownship): /"h�
Parcel Number �
If buying on contract: Owners name �+� simple owner�
-^�� Township
— - '
or legal description shown on tax statement:
��i. SE �<. �!- 3 - /�" . S a
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:
�hereby certify the above statement is true, correct and complete.
� .dti,� y�!����xD�� �'_��� �t��,
S nat e %%%i� Strret AaCress
County Township
ana
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 i edi�ely
surrounding residential improvemen�
Other Land �
MAY 2 � �g?9
Total Land
True Cash
Value _
� �.� �>> �sa
(2) - ° —
(3) oZ S a
Residential Improvements Iling (4� a 9 8' o
� / ��DB�g��E#��5) o l
�/ TotaIA�DITOR _ (6) � 9 � o
Other Improvements (�) °Z"O
�Improvements - Line (6j plus (7) equals (8) (8) � o o �
�.�eby certify the above is true. correct. and complete. _
ol Assessor
/� - ACTION BY AUDITOR -
!� . lL � ll .r,[i,nAl�i
Assessed
Valuation
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Homestead
Valuat�
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Da:e
Date: -5 � - / �