Homestead_Winstead (3)FORM HC 10 1979
Presui0e0 By $Iate BwrO ol ia. fqmmissioners
io Be flle0 in Oupbcate
CLAIM FOR HOMESTEAD PROPERTY TAX CRE�IT FOR YEAR 19 7 9
SEE BACK FOR FILING INSTRUCTIONS QOS ���� ��
� (We) ��.�.�a_�.. �% l,- _��,... � �, -t-� �=—�`d�
��larch, 1979 I, (We) occupied as our.principal place of residen
which a Homestead Property Tax Credit is hereby being claimed:
— certify that on the 1st day bf
following described real property for
(We) � owned �/ � _�� 9yro —��
❑ are buying under contract �'��" "�°
❑ have a beneficial i,{�terest in the taxpayer �_
Property Description
Taxing District (6iFy;—��ra, Township): /�x
Parcel Number
Ii buying Ofl contract: Owners name ��ee sfmoie ownerl
'J!J/�-� I � Township
�e�-L
�-
or legal description shown on tax statement:
, S£. L� 3G-a-� z . G�lvS a.�
.� .� . �7G R�
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.
x,�we. �S � Cl%,�za�e,a.G� /� . ii . ��'' l
AOdr¢55
County
Township
G;y. Scaie an0 2ip CoOe
Individual either owns or is buying under a contract ihat provides he is to pay the property taxes
on ihe residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding �on� acr imm�ately
surrounding resident' I im ove�nts �
Other Land
Total Land �J;A;' 3 p 1979
Residential Improvements
(�J /�, �������
� auoiroR
Other Improvements
Dwelling
Garag�
Total
Improvements - Line (6) plus (7) equals (8)
by certify the above is true. correct. and complete.
A552550�
Approved
True Cash
Value
(�) � 1
(2) — ° —
(3 ) a� �
l4) � 0 7S�
(5)
(6) � D �75�0
(� ) --- o
(8) � 0 7S0
- ACTION BY AUDITOR -
Assessed
�
Homestead
....j/�j����
- � � '� �����j�
.
♦ �