HomeMy WebLinkAboutVeterans_Alvisn
�"' APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
�• � WWI VETERANS AND SURVMNG SPOUSES OF CERTAIN VETERANS
e,. f State Form�12662 (R97S08) �•^. �,
Prewibed �y Ne Departmem of Local Govemment Rnance "�p qa ��
���RUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one box m�e cyfe ed� h�jledSaeGrviving
spouse who receives a deduction under Section IV may not receive a deduction und��SecNb�
FILING DATES: ZOOS
REAL PROPERTY: DURING THE 12 MONTHS BEFORE JUNE 11 OF THE YEAR THE DEDUCTION IS TO PQ�R�.1 9
MOBILE HOMES (6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR WHICH TI-i�l DIVIDUAL WISHES TO
OBTAIN THE DEDUCTION. �py��t �
[.� I Totaily disabled veteran (or veteran a( least age 62 viilh at least 70% disa6iliryJ or surviving spouse = Not to ceed����
Complete seccions I, V and VI. (IC 6-t.7-� 2-�a) GIBSON COUNTY AUD
�'j II Partially service-connected disabled veteren OR surviving spouse - Not to exceed 524,960
Complete sections II, V and VI. QG 6-t.t-12-13) � � �'y
❑ III Wodd War 1 Veteran - Not to ezceed 578720 ���
Complete sections III. V and VL QC 6-1.1-12-17.4)
❑ IV Surviving spouse of Wodd War I Veteran - Not to exceed 518.720
Complete secUons N, V, and VI. (IC 6-1.1-12-16)
Name of applicant (�rst, middle last)
Pddress (street arM mber, dty, stafe, ZIP code) County �,
� s. c " P c�-rv�/ S�- v on/
Applicant ( does I dces not ) own property with another individual(s) besides spouse and/or anoNer veteran.
i
This applira6on is made for the purpose of o6laining S ��f'�. deduction from ihe assessed valuation of the fdlowing described taxable
property for fhe year 20_
Taxing District (city, town, township) Is the property in questlon: P i or Key nu ber
❑ Real Property ❑ Mobile Home QC 61.1-7) ���p? Q�' ,3-G�.03�'Oad�
• . . � .. •' . -. ..- . . - i'. . ..
L7 AppGcant was a mernber o( tlie U.S. Armed Forces for at leau 90 days (rrot necessardy dunng war brne} �
B. ❑ Appfinnt was hawrady disdiart�ed.
C. � Appficant is: ❑ Tdally disaded; a ..
❑ At least age 62 wilh at least 10% disabtliry
D. � AppGrenYS disability is eviderroed by ❑ Cerlificate d efigibdrty Gom tl�e Indiana Departrnent W Veterans Afiairs;
❑ Perisim cerlifi�te;
❑ Award of wmpensalim hom Veferans Adrtrinistration or Departrnent of Defense; or
❑ Vetera�a Administration Form 2(Y5455 `fax Ahatemart Certificate'
E. � The aswssed valualim (al 1 W%) of the property for which Uie deduaion is daimed (may rpt exceed 5173,000) $
F. �1 �Applican� is tlie survivmg spouse of an iMividual who would have qualified fa the deduction under this sefbon when he or she was alive.
-(Age oJdeceased veierdn on date oideaM )
• . � ..
A� Applicant was a member of the U.S. Artned Forces during any of its wars.
B. ❑ Appliwnt was honorably discharged.
C. � Applicant has a serviceconnecled disability of at least 70%
D. � ApplicanYs disabiliry is evidenced by: ❑ Certificate of eligibility irom the Indiana Departrnent of Velerans Aftairs;
❑ Pension certifiwte;
❑ Award of wmpensation from Veterans AdminisVafion or Departmeot o( De(ense: or
❑ Veterans Adminisiratlon Fortn 245455'Tax Abatement Certificate'
E. � Applicant is the surviving spouse ot an indiviA�ial whn wniilrl hava qualfied for the deduction under [his seclion when he or she was alive.
(Age o! deceased veteran on date of death �� 1
•
�r] Appficanl is a veteran of Wald War I. •• . .
� Applicanfs disab3iry is evidenced by: ❑ Lerier trom Veterans AdministraUm a Departrmnt of Defense: a
� Drsdiargedowments
C. O The assessed valuatirn (at 100°/,) ot the properry fa vAridi the deducUOn is daimed (may rrot exceed 8163,000) S
D. � The propeiry is the app�nYs Pruidpal residence. -
E. O rne appi'xam wmed me pmperry (or was buyvg it u� oorNaa>+or at �east me year eer«e me date ar mis appucatia,.
• � • �