HomeMy WebLinkAboutHomestead_Maikranz (4)FORM HC 10 1979
Prescribed By State Board at Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19/1?
To Be Filed in Duplicate .
�(We)
certify that on the 1st day of
March, 19-Y--�4 I, (We)
upied as our principal
lace of residence the following described real property for
which a Homestead Property
Tax Credit is
hereby
being claimed:
"?6
I, (We) ❑ owned
❑ are buying under
contract
❑ have a beneficial
interest in the
taxpayer
Property Description in
County Township
Taxing District (C-itr, Town
Township):
Parcel Number
or legal description shown on tax statement:
P t. 'v i1/£ y / cp -
If buying on contract: Owners name Ilee 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
Any other counties in which individual owns or is buying real property: County Township
hereby certify the above statement is true, correct and complete.
'Signature
L 1-o 1-7- Q-5:ie e
Address
City. Stale and Zip Code
Individual either owns or is buying urider 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) acre immediately _
surrounding r enal irtve is (1) -5- o ho
Other Land �° (2) 'P 7 e? o
So3 a
Total Land 2; 1979 (3) g a o o
Residential Improve (a) / y a o
Dwelling
Garage (5) P °
AUDITOR
Total (6)
Other Improvement (7) -
Tor-' Improvements - Line (6) plus (7) equals (8) (8) / 5/ y o ` C
I W-certify the above is true, correct. and complete. &-77'Z9
Aaseasor
- ACTION BY AUDITOR -
Approved
s /V-;79
Date
Homestead
Valuation
DO;
Date: A -n1977