HomeMy WebLinkAboutHomestead_Lamey (24)FORM HC 10 1979
Neuri�ea By Sta;e Boara of ia. Commissioners
To Be FileU in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 192�
SEE BACK FOR FILING INSTRUCTIONS
�(We) � certify that on the 1st day of
March, 19�, I, ( occupied our principal plac of residence the following described real property for
which a Homestead roperty Tax redit is hereby being/ claimed: �� ��_��
I, (We) ❑ owned �CO -�.3-�c5'� ����(� VJ C/V
❑ are buying under contract
❑ have a beneficial i terest in the taxpayer
Property Description in �
Taxing District (C.ity—Towrt; Township):
Parcel Number
If buying on contract: Owners name �'� "`"o1e °`"et�
�^y� , Township
or �legal description shown on tax statement:
y� c�(� �7� /S =�—/ O / 7�.j u�C tiltQ_
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 utiliied to produce income
Any other counties in which individual owns or is buying real property:
hereby certify the above sta ement is true, correct and complete.
7
� � �n�i� ��.,; ;� .� /�. !1
Aaarezs
County Township
arw Zio �e
ual 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 JUry � � j979
� �/��1{y=QiCA
l AUDITOR
Other Improvements ��
Dwelling
Garage
Total
�Improvements ; Line (6) plus (7) equals (8)
�,.ereby certify� above is true. correct. and complete.
Signamre ol nssessor
Approved
True Cash
value
(�l �o 0
(2) �S"i'l
(3) %'�"O
�a� 3s 3 0
(5) / 3 0
(6) �(o �o a
(7 ) 9 �0 0
�s� i« z o
ACTION BY AUDITOR -
Assessed Homesiead
Valuation Valuation
� ,,,,,,,,,,,,,,,,,,,,,�
0
S'�'—L� —7�
Darc —
Date: �O_l�/_//�