HomeMy WebLinkAboutVeterans_McCormick'3 APPLICATION FOR TAX DEDUCTION FOR DISABLED VETE ���
` _ E WWI VETERANS AND SURVNING SPOUSES OF CERTAIN V�T �N�
State Fwm 126621R11 I 7POB) ��
�' Prewi6ed by �he Departmerit of Local Go.emment Finante
�3TRUCTIONS: Please check appropriate box(es) pertainim� fo tax deduc6on. (More than one bo� rney t�e �etke�� however, a surviving
spouse who receives a deduc6on under SecUon IV may not �eceive a deduc[ion under Sec6on ll.)
FILING DATES: -�y�
REAL PROPERTY: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT. �/�t6� ��"
MOBILE HOMES (IC 6-1.1-7) OR MANUFACTURED HOMES NOTASSESSEDAS REAL PROPERTY: DUP3ING TF��f�E (12) MONTHS
BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN T��g�8B1JLmIQMT.Y
� I 7otalty disableE vete2n (or veteian at leasf age 62 wifh af least f09'o disebility) or surv'rving spouse - Not to exceed 512.480
Complete sections I, V and VI. QC G1.1-12-14)
❑ II Partially service-connected disabled veteran OR surviving spouse - Not to exceed S24,960
ComD�ete sections II, V and VI. (IC �7.1-12-13)
❑ III WoAd War I Veteran - Nol to exceed 518,720
Complete secfions 111, V antl VL (�C 61.1-12-17.4)
❑ N Surviving spouse of Wor1d War I Veteran - Not to exceed 518.720
Complete sections N, V, and VI. (IC 61.1-12-16)
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Name of apptirant (first, mid e las� _ � �� nC'L�
Address'-�--' -ndnumber, �ty, stat , arMZlPcode) County
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Applirant ddces Qdces not � own property wiN another irWividual(s) besides spouse antllor another vetemn.
This application is made fir tha purpose of obtaining 5�7 � V deduction from the assewed valuation of the fdlowing described taxeble
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proPerty far the year 20_ ' ' -Q- ' ' - 0— '��/—' .
T i istrict (ci towq townsliip) s t e pmperty in Ques[ion: �'�-Pam.ei or Key number
� Real Pmperty ❑ Mobile Home (IC 6-1.1-7)
� � • • i • . . y ..-� _
�❑ Appficard vras a member af ihe uS. Artned Forces for at least 90 days (lroP necassany durirg wer tlme}
. 0 MP&ant was honorady discharged.
C. ❑ A�6rant's: ❑ TotaOy dsabled; or
.t age 62 with at I�st 10% disabi6ly
D. ❑ AppGranYS disaWLty ¢ e�ridenced by � Certifinte of eligibiliry from tlie Indiana DepaMrent o( Vete2ns Afttirs;
� Pension certfirete;
n Award of compensatim from Veterans Pdminatratlm or DepartrneM of De`,ense; w
=_terans Administration Fortn 245A55 "Taz AbatemeM Certifinte'
E. ❑ The assessed valuafion (al 700%) d ihe property fw vAridi fhe tletluction a dtimetl (may rrof exceed 5143,160j S
F. �Appfirvnt is fie survivuig spouse af an uWividual who xvuld have QuaGfied fw ihe dedudion unaer Uiis section when he or she was alive.
(Age d dersased t�eteian on date d death )
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A Applicant was a member of the U.S. Artned Forces durirg any of its wars.
B. Applicant was honorably discharged.
C. Applicant has a seMce connected disability of gt Ieast 70%
D. ❑ AppGcanYs disabifiry is evidenced by M� Certifirate ot eligibiliry from the indiana Department of Veterans Aftairs;
❑ Pensbn certificate;
❑ Award of compensation from Veterans Administratbn w Department of Defense; or
�lleterans Administretion Fortn 20-5455 "Tax Abatement Certificate
E. ❑ Applirant is Ne surriving spouse of an individual who would have qualified for the deduUion under this seabn when he a she vras alive.
(Age of deceased veferan on dafe W death )
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A QAApp&ant i5 a veteran a( World War I.
B. ❑App&aM's servite is evidenceC by ❑ letter finm Ve[eraru Atlm'u�atration a Departrnanl o( Defense: w
❑ Disdiarge donimenis
�❑ me assessed �an,amr� (ae ioox) or u�e amveM ror wbd, me aeau�«, is aair�d (may nor exceed szoe,soo� s
. ❑ The pmperty a the apP6ranYs P�P� rnsidmce.
E. ❑The app6cant wmetl the pmperty (or was 6 yring it under confrac� for at least one year before ihe date of tha appfication.
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