HomeMy WebLinkAboutVeterans_Hedge.,r:��?
�'l:
APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
W1NI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
S�ate Fwm 12662 (R6 / f0-O7)
Prescnbed by the Departrnent of Laal Govemment Finance
INSTRUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one 6ox may 6e checked; howeve� a surviving
� spouse who receives a deduction under Secfion IV may not receive a deduction under Section ll.)
�JG DATES:
REAL PROPERTY: DURING THE 12 MONTHS BEFORE MAY 11 OF THE YEAR THE DEDUCTION IS TO APPLY.
MOBILE HOMES (6-1.1-7): BETWEEN JANUARY 15 AMD MARCH 31 OF THE YEAR THE DEDUCTION IS TO BE EFFECTIVE.
t;
❑ I Totally disabled veteran (or veteran atleast age 62 wifh at least 10% disability) or surviving spouse - Not to exce"�d ,00
�// Complete sections I, V and VI. (IC 6-1.1-12-14) ���j 1�
OlJ II Partially service-conneded disabled veteran OR surviving spouse - Not to exceed 512,00� �� Ss�
Complete sections II, V and VI. . pC 6-1.1-12-13)
�� 00�
❑ III Wodd War I Veteran - Not to exceed 59,000
Complete sections III, V and VI. (IC 6-1.7-12-17.4)
❑ N Surviving spouse of World War I Veteran - Not lo ezceed 59,000
sedions N, V, and VI. (IC 61.
�
does noJ� own properly with another individual(s) besides spouse and/or another veteran.
�
FE� � � ��
(/��
This application is made tor the purpose of obtaining $��� dedudion hom the assessed valuation of the (olowing described taxable
town,
-� a-o'1-303-001. 18`7-0
Is the property in question: Parcel or Key number
�' Real Property ❑ Mobile Home QC 6-1.1-7) F� /_-�J___Q
AppGcaM was a member of the U.S. Anned Foroes for at least 90 days (not necessanly durirg war time).
B. ❑ AppGpnt was horrorably d�arged.
C. ❑ Apptipnt is: ❑ TotaDy disabled; or
❑ At least age 62 witli at least 10% disability
D. ❑ AppluanPs disabtlRy is evidenced by
❑ Certifinte of eligibilily 6om the Indiana Departrnent of Veterans ARairs; ��
❑ Pension certificate;
❑ Award of compensation from Veterans Administration or DepaNrent of Defense; or
❑ Veterans Administration Form 245455 "Tau Abatement Certficate'
E. � The asusud vah�ation (at 100%) oi the property for which the deduption is da"vred (may nof exceed S54,OOQj $
F. � Appticant is the survivirg spouse of an uWividual who would have qualifie0 for the dedurtion under ihis section when he or she was alive.
(Age oldeceased vete(en on date o/death )
A Ll Applicant was a member of the U.S. Armed Forces during any of its wars.
B. � Applipnt was honorably disrharged.
C.,�I Applicant has a serv'�ce-eonneded disability of at least 70%
D. � ApplicanPs disabilily is evidenced by: ❑ Certfipte of eligibility Gom the Indiana Departrnent of Veterans Affairs;
❑ Pension ceNfiwte;
� Award of compensation 6om Veterans AdminisVation or Department of Defense; or
❑ Veterans AdminisUation Fortn 20.5455'Tau Abatement CeAificate'
E. � Applipnt is fhe surviving spouse�of an individual who would have qualified for the deduction under this sec6on when he or she was alive.
(Age oI deceased veteren on date of
App6Canl IS a Veffi2n ot World War I.
App6nnPs disabady is evidenced by ❑ Letter from Veterens AdminisVation or DepaNrent of Defense; or
❑ D'scharge documents
C. ❑ The assessed vaNation (al 100°.G) M the Properly for whirh Ne deduntion's dauned (may not exceed 578,000) $_
D. � The properry is the appiinnYs pm�dpal residence.
E. � The appfiraM owned Uie properry (a wds buyrng d under mntracQ for at least one year betore the date of ihis application.