HomeMy WebLinkAboutHomestead_Walker (2)FOAM HC 10 1979
HescnDeO By SUte BoaN of ias Commissioner5
To Be FileO in DuDlicate
CLAIM fOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 � 9 �
SEE BACK FOR FILING INSTRUCTIONS O�l� p�gab. QQ
`�(We) OC�_- �� �1-� �� �- ��ti-� 7�• certify that on the 1st day of
� arch, 19��, 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 interest in the taxpayer
Property Description in � County ��-- - Township
Taxing District (6iEy,-Town, Tow�sHi�j: ��• �k-.�-�-�-� -
Parcel Number or legal description shown on tax statement:
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,
If buying on contract: Owners
Contract recorded in Recorders Office - Record No. Page
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.
ire //q �/� � Strret Aaaress . ' Giry. Su�e anE Z10 �e
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' 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 t(one) acre immediately
surrounding residential improvements
Other Land �p � � � �
Total Land `��
Residential Improvements ��N 2�� �979 Dwelling
Other Improvements
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� AUDITOR
Tr�lmprovements - Line (6) plus (7) equals (8)
I..._ .:oy certify the'above is true. correct. and complete.
Signamre ol Assessor
True Cash
Value
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(2)
(3) � `'!z°
(4) /�
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(�) _�/
(8) /�d a o
- ACTION BY AUDITOR -
Assessed
Valuation
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Date:
Homestead
Valuation
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