Homestead_Zehner (2)FORM HC 1D 1979
PrescriCetl By Sta�e BwrO ot ia. Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19 79
Ta Be Filea in OuD����e
SEE BACK FOR FILING INSTRUCTIONS O� S�6'9 (� o�
�� (We) �-e--!�M �� �,��-a 0� � certify that on the 1st day of'
v�arch, 1�2, 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, (iNe) C�owned
❑ are buying under contract .
❑ have a beneficial iryi�rest jn the taxpayer
Property Description
Taxing District (@ky-Tbvan, Township): %'1'+—�s�
Parcel Number.
If buying on contract: Owners name �'� 51np1e °""ef�
��-/7-O� ao -,a�� 9�� - �a/
`-i''/�t�.�( QtsY,�-�-^-'f Township
- -,. _ _i
or le al description shown on tax statement:
. 5 i,�l ,� S � � .SD
Contract recorded in Recorders Office - Record
If any portion of the residential siructure 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:
i hereby certify the above statement is true, correct and complete
�/��� .� �ie % (JD ;L' ���
Sveet naaress
County Township
City. Stare antl Zip Goae
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 Improvements
,IUN � 1979
Dwelling
Garage
Total
Other Improvemen �� i �����i�
To� '-lmprovements - L nK e(6) plus 1�[ry (8)
i-�3� certify the, above is„true. correct�. a�nd complete.
nssezsar
Approved
True Cash
Value
(� ) �� Ov
(2) — ` —
(3) Jl a--a
(a) 'S�D �0
c5� � o--o
(s) '� � � c�
(7) % O
cs� `f 7.�'0
- ACTION BY AUDITOR -
Assessed
Valuation
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Homestead
Valuation
5--a � -� 9
Da:e
Date: _—_1�L_[�/S