HomeMy WebLinkAboutHomestead_Martin (16)FORM HC 10 1979
HewiCed By Siale Bw�tl oi ia. Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�
io & FileO fn Duplicate
Property Description in /�+-�-m County � Township
Taxing District (G7ty; Town�-�ownship): ��• ��/z-a—v��—
Parcel Number or legal description shown on tax statement:
Ti�-e�- "�i �, i/
If buying on contract: Owners name u� simo�e
Contract recorded in Recorders Office - Record No. Page
If any portion of the residential structure or the land, not exceeding one (7) acre that immediately surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce income
5�.��1�T. C
Any other counties in which individual owns or is buying real property: County Township
'-hereby certify the above statement is true, correct and complete.
� .
�utird,r ��,�u.c�rcrr� iii�ucc7� — gv�c i/urcv�_� ra.uc {ru.�.�.i vo: ry�uu� �r.k_
- Signamre � Svret Aaaress � Gi:y. Siate entl Zio Cotle� ^i^/J�
Y �� - �-s = /979 yi«� �
' 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 residen�i�r�m� �
Other Land
Total Land
Residential Improvement��N 2 ! i979
C/1 • �r�
Other Improvemenis "
i
,. /
. . •-
True Cash
Value
(7) $ 3 O
(2) —
�s> g 3�
Assessed
Valuation
�. 8 0
�8�
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(�) —
To"' �Improvements - Line (6) plus (7) equals (8) (8) L�- 2�—° '�-a-7'�"
I;��y certify the above is true. correct. and complete.
Sigwwre o� Assessor
- ACTION BY AUDITOR -
Homestead
Valuation
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Date: �D� �/