HomeMy WebLinkAboutHomestead_Kissel (7)FORM HC 10 1W9
PreuriDea By State Baa�O al Ta. Commi55ioner5
CLAIM FOR HOMESTEAO PROPERTY TAX CREDIT FOR YEAR 19Z
io Be FileE in Duplicate
SEE BACK FOR FILING INSTRUCTIONS �D�� � y��� �T
^ /� U vC!
��We) �l� ��u�� Q a� ��--?�• �" - certify that on the tst day of
arch, 19�-�. I, (We) occupied as our principal plac�of residence the foltowing described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned �cr-v��-O�-��-Q��.dT� �0�7`
❑ are buying under contract �
❑ have a beneficial interest in the taxpayer
Property Description in �-�-�--.-�-
Taxing District (Ci2yrFew+r, Township):_
Parcel Number
If buying on contract: Owners name "� Sinp1e °"'"e"
nty Township
.,, J
or legal description shown on tax statement:
P�. LU � / — '/ - /l �. %/2cY—o
Contract recorded in Recorders Office - Record No
If any portion oi the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
struc[ure 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.
County Township
' 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
surroundinq residential improvements
Other Land
Total Land
Residential Improvements . �
� � welling
� arage
l
Total
Other Improvements JUN G 1979
T�" Improvements - Line (6)�p/lus � quals 1
I�by certify the ab�is y�e. rre . a plete.
/1 n Ae_ � P��
True Cash
Value
(�) _3'�0
(�) 3-�-�
(3) -�� o
(4) a 1 �! o
(5) / so
cs> � a y o
(7) a oao
�s> `/ a 5 0
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
�70
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oa,e
Approved: �"1�Q � Date: � �� ��