Veterans_Morrison (3)°` n�" APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, Q�� 9 �
y,—� �, ;E INWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERAN
';� y � ' State Form 726fi2 (RB / 4-0d) \C .
...� .
Presaibed by the Department of Local Govemmeni Finance
iNSTRUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one box may be checked; however, a surviving
spouse who receives a deduction under Section IV may not receive a deduction under Section ll.)
�NG DATES:
REAL PROPERN: DURING THE 72 MONTHS BEFORE MAY 11 OF THE YEAR THE DEDUCTION IS TO APPLY.
MOBILE HOMES (6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR WHICH THE IND�I e�}�AL�(JISHES TO
OBTAIN THE DEDUCTION.
❑ I Totally disabled veteren (or vete2n at least age 62 with at least f0% disabilityJ or su in s�$us - N t e9'S��,480
Complete sections I, V and VI. (IC 6-1.1-12-14) �,
❑ II Partially service-connected disabled veteran OR surviving spouse - Not to exceed 524, 60 g 2pQ�
Complete secUons II, V and VI. (IC 6-1.1-12-73) �VL 2
❑ III Wortd War I Veteran - Not to exceed 518,720
Complete seclions III. V and VI. (IC 6-7.1-12-17,4)
❑ IV Surviving spovse of World War I Veteren - Not to exceed 578,720
of applicant
Address (sf2ef
seqions N, V, and VI. (IC &1.1-12-1
rriddley/asQ
( does / does not ) own property wi[h another individual(s) besides spouse and/or another veteren.
�BSO (/ NT.� pUDIT�F
This application is made for the purpose of obtaining 5�OiT�iJ deduction from the assessed valuation of the following described taxable
property for the year 20�.
Taxing District (ciry, town, township) Is t property in question: Parcel or Key number
Reai Property ❑ Mobile Home (IC 6-1.1-7)
� . . � .. •' 1'. . ..
�� Applicanl vras a member of fha U.S. Armed Forces for at least 90 days (rwt necessarily dunng tvar fime).
B. ❑ App6cant vas honorably discharged.
C. ❑ Applicant is: ❑ Totally disabled; or dG -ia -o � a�/ �aa. ��6a�/
Q� �a�
❑ At least age 62 vrith at least 70%disability ' �� �
D. � ApptipnPs disability is evidenced by
�ivES �?�-�a-o� ���- 00�.075� a�
❑ Certificate o( e6gibiliry from the diana Departrn nt o Ve erens avs; P�� �
❑ Pension certifipie;
❑ Award of compensation fran Veterans Administration or Department ot Defense; or
❑ Veterans Admwstration Fortn 205455'Tax Abatement Certificate'
E. �� The assessed vahiatlon (at 1 WYo) of ihe property for which ihe deduction is daimed (may rrot exceed $773,000) 3
F .pplinnt is the surviving spouse of an individual who would have qualified for Me deduction uMer ttv's s�en h�
(ilge of deceased veteran on date ot death ) -�- �
A. l
C. L�CX/_v�� • Q-�
any of iis wars.
�� � �n � ��� . � of eligibiliry from the Indiana Department of Veterans ARairs;
a� �� i�
from Veterans Administration or Department of Defense; or
Form 20-5455'Tax Abatement Certificate'
E.`E �� C1_� y_ -!r UN �Id have qualified for ihe deduction under �his section when he or she was alive.
Departrneni of Defense; w �
C. U �/_ . i deducfion is daimed (maynot exceed 5163,000) 5_
D. G LQJ
E. G ,,_,�__ _, ,_..__,-,..... l act) (or at least one year befae the date of Utis appGCation.