Homestead_Krueger (2)FORM HC 10 7979 To Be FiIM in DuDlicate
HescribeE By Sute BoarE of Ta. Cammissioners
CLAIM FOA HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19Z�
SEE BACK FOR FILING INSTRUCTIONS �S - a�9 9b
�(We)��- � 6-N�-�� ��- 'D` , • certify that on�the 1st day of
arch, 1 1`L, I, We) occupied as our principal place of residence the following described real property for
which a. Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial ipterest in the taxpayer
Property Description
Taxing District (GePq-�vw�f, Township):�'1��.
Parcel Number
If buying on contract: Owners name (�� =�mple owner)
��-/e� a�- ��- � `�9G- a�-/
_County Township
legal description shown on tax statement:
�� /1� Lr ) 1� r�- � — /� �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: County Township
hereby certify the above statement is true, correct and complete.
�
��2�1� � ���. �..��. �z...—.,,-- /P12 �`3 D..�u�..�..�a o�•
S�gnature Sveet ACtlre Giry. State en0 Zip CoCe
` 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 immediately
surrounding residential improvements
Other Land
Total Land ���
Residential Improve�ts� Dwelling
, �g79 Garage�
��� Total
Other Improvements/�/J y/� R
T% Improvements'�Ciri " ) plus �j���als (8)
I�zby certify the abo _ is true. correct. and complete.
Assessor
True Cash
Value
( � ) .� D-c�
(2) - o -
(3) .5 D O
c4� � � 9�-0
�s�
(6) � -l�'�2.t�
(7) - o -
�a) / � 9�0
s
Assessed Homestead
Valuation Valuation
.
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Date
- ACTION BY AUDITOR -
,_ Q� Date: 7` 9- 79