HomeMy WebLinkAboutVeterans_Brunson""�. APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, �����' '
�._ � WINI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS � r
SlataFartn12662(R11ItP-08) JUN 2 2 2012 �
�„ , Prascribed by ihe Departmerd of Loral Govemment Finanm
INSTRUCTIONS: Please check appropriate box(es) pe�tainirg fo tax deduc6on. (Moie than one box may be cf�ecic���surviving .
spouse who receives a deduc6on under Secfion IV may not �eceive a deduction under Sectlon ll.)
FILING DATES: GIBSON COUNTY AUDITOR
REAL PROPERN: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT.
MOBILE HOMES (IC 6-1.1-7) OR MANUFACTURED HOMES NOTASSESSED AS REAL PROPERTY: DURING THE 1WELVE (12) MONTHS
BEFORE MARCH 31 OF EACH YEAR FOR WHICN THE INDIVIDUAL WISHES TO OBTAIN THE DEDUCTION.
� I Totally disaWed vete2n (or treferan at leasf age 62 with at least 1� disebility) or surirving spouse - No� lo e�creed 512.480
Canplete sections I, V and VI. (IC 6-1.1-12-14)
� 11 Partialty service-connected disaWed vetersn OR surv'rving spouse - Not to exceed 524,960 � / �/�
Complete sectbns II, V and Vi. (IC G1.1-12-13) j� n� � ° �
❑ III World War i Veteren - Not to ezceed 518,720 j•--v�-Y �vZZx/
Complete secfions III, V antl VL (IC 61.1-12-17.4) �
❑ N Surviving s{rouse of Worid War I Ve;eran - Not to ecceed 518.720
Complete sections N, V, antl VL QC 61.7-12-16) --
Name t applicant (first, miCdle, las�
Address (street and number !�y ��_�= A�71P code) County
c (B.SC
Applicant Qdoes Qdoes not ) own property wilh another individuat(s) besides spause antllor anoNer veteran.
This appliption is made for fhe purpose af obtaining S 3 7 / YO, -- deduction from the assessed valuadon of the fdbwing described taxabie
property fw the year 20
Taxirg OisVict (city, fown, lownship) Is the properry in Question: Pamei w Key number
❑ Real Pmperty ❑ Mobile Home (IC 6-1.'I-7) ,� _o Qo / S83 oa
� � �• i..
A� AppGqM was a member af the U.S. Artned Forces for at least 90 days (rrot newssany dunng warfime�
B.�App&antwashonaadydisdia�ged. �
C. APP&ard Ls: ❑ TotaOy 6sabled: or
� At leasf age 62 with at I�st 10% tlisabi5ty
D. � AppfxanYs disabi6y a evidenced by: � Certfic�te of digidliry from Uie Indiana Departrrrent d Veterans Affairs;
❑ Pensbn certifra�:
❑ Avrard ot mnpensation from Veterans Pdmmistration w DeparimeM of Defense: w
❑ Veterans Adrttinstration Form 20.5455 Tac ADatement Cenifinte
E. ❑ The assessed veluation (at 100%) of Me property for vhtich ihe deduction is damed (mey rrot exceed $143,160� 8
F. � AppGcant is the surviving spouse of an cWividual who would have qualified for the deduction under ihis section when he or she was alive.
(Age d tleceased velaan on date ddeaih�.J )
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A� Appticant was a member of Ne U.S. Artned Forces durirg any of its wars.
B. � Appiicant was hrnwably discharged.
C. � Applirant has a seMce connected disabiiiry of at least 10q
D. � Apptipnt's disability is evidenced by � Certifrote ot eligibiliry from the Indiana Department of Veterans Affairs;
❑ Pension certificate;
❑ Avrard of compensa�on from Veterans Administrabon or Departrnent of Defense; w
❑ Veteraru Administretion Form 20-5455'Taz Abatement Certficate
E. � Applirani is the survrving spouse M an indhridual who would have quaiified for ihe deduUion under this sectbn when he w she was aiive.
(Age W tleceesed vete�an on date o7 deafh� ;S !
•
A QApp6cant's a vefaan of NbM War I.
�. �App6rarri's service is erider�ced by ❑ Letter from Veterars Adrtmistrafion a Departmeni of Defense; w
❑ Discharge Aaaiments
c. Q rna assessed van,ation (a� 100°,6) of u,e croce�v �r vAud, u,e dmuction "s aaimed (rr�ey not ezceeU s2os,soa) s
D. Q The pmpary s ihe appGCanfs prcxipal resitlence.
E. �The app6mnl amed the pmperty (w wes buyti'g rt �aMer oontrac� fw al leasf one year befure the date of fhis app5ption.
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