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HomeMy WebLinkAboutHomestead_SharpFOqM HC 10 1979 � To & FileE in DuDlicate PrescriEeE By Stare BoarG ol Tav Commissianers CLAIM FOR HOMESTEAD PAOPENTY TAX CREDIT FOR YEAR 19 79 SEE BACK FOR FILING INSTRUCTIONS ��Q�S�7 �(Wel �,(%Jy / �. °�'" ��.e'u�c°-�-Fertify that on the 1st day of arch, 19 I, (We) ccupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) I� owned ❑ are buying under contract ❑ have a beneficial interest i Property Description a�-/Q -.�.� - 3oa- oG/ s47-��.� the taxpayer Taxing District�.CiEy-%awn, Township):__�� CJ Parcel Number or / If buying on contract: Owners name ��� simo�e Township on shown on tax statement: 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 buyin9 real property: hereby certify the above statement is true, correct and complete. County Township Coae ' 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 residentia�pr�vem�s � � Other Land Total Land Residential Improvements JUN �`� 1979_ Dwelling � � Other Improvements AUDITUR Garage Total vements - Line (6) plus (7) equals (8) rtiTy the apove is t�e. correct, and complete. 4ssessar - 1 I Approved True Cash Value c, � ..� a a (2) 39� (3) � Q (4) �0 7/O �5� — o — (6) � 7/ O Assessed Homestead Valuation Valuation /7a , ., (7) 5 �l D �8c�� �a� 7� 9 0 3� �~—/7-7i Da�e Date: — Z