HomeMy WebLinkAboutVeterans_Resler..°'^ APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
._ E INWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
- Stale Fofm 12662 (R77 / 1408)
�,. , Prasuibad by lha DepaAment N Lmal Gwemment Firence
INSTRUCTIONS: Please check appropriate box(es) pertainirn� to tax deduction. (More fhan one bnx may be checked; however, a surviving
spouse wFro receives a deduction undei Section IV may not receive a deduclion under Secfion 11.)
FILING DATES:
REAL PROPERN: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT.
MOBILE HOMES (IC E1.1-7) OR MANUFACTURED HOMES NOTASSESSED AS REAL PROPERTY: DURING THE TWELVE (72) MONTHS
BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DEDUCTION.
� I Totally disabled vete2n (or treteran af leasf ege 62 wrth t I t� isa6ili o su � spouse - Not to exceed 512,480
Complete sections I, V and VI. (IC &1.1-12-14)
� II Partially service-cannected disaWed vete2n OR wrvrving spouse -
Complete sectbns II, V and VL QC G7.1-12-13) -�
❑ 111 WoAd War I Veferen - Not to exceed 518,720 ��� 317012
Complete secfions III, V and VI. (IC 61.1-12-17.4) C�
❑ N Surviving spouse ot World War I Veteran - Not to exceed 518.TL0�'
sections N, V, and Vl. (IC 67.
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Applirant Qdces Qdaes not ) wm property with another individuat(s) besiEes spousa andlor anoNer veteran.
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This application is matle for the purpose of obtaining S J� 7 7� O• -�deducfion from lhe assessed valuation of the folbwing described t�able
far ihe year 20_
Is the pmperty in questlon: Pamel w Key number
❑ Real P(operty ❑ Mobile Home (IC 6-1.1-7) �(p--��'Q% –
a�Aaa�ica(rt �ras a memcer or me us. amed Foroas tor at �eas� 90 days (ru.� necgssanH d�,rv'y warsme).
B. eAPP&ant was honaady dischaiged.
C. [�AAppGnrd's: ❑ TofaCy d�saWed; or
� At least age 62 vrith at Imst 10%dsad8ry
D. �AppEcanPs d�saWLty a evidPnced by. Q Cerlificate of d'gihi6ly from �he Indiana DeparVrent d Vete2ns ARairs;
❑ Pensiwi certifirate:
❑ Awaid of campensation from Veterans Administratim or DepartmeM of Defense; w
❑ Veterans Adrttinistration Form 2P5455 "rarz Abatement CeAifxate'
E. Q The assessed valuatbn (at 100%) of Ne praperty fix wtich ihe deduction is dairtred (msy rKd exceed 8143,160) S
F. ❑ Applicant is the survtving spouse of an mdividual who would have qualifx.W for ihe dedudion under ihis section when he w she �ras alive.
(Age d tleceased veteren on date ddeath )
A. � Applicant was a member of the U.S. Armed Forces during any of its wars.
B. [� Applicant was honwably discharged.
C. � Applinnt has a service connected disabiliry honf at least 10°k
D. � AppiiranYs disability is e�ridenced 6y !�J Certificate of eligibiliry from the Indiana Department of Veterans Af(airs;
❑ Pension certificate; �
❑ Award of compensabon from Ve[erans Adminis[2tlon w Departrnent of Defense; w
❑ Veterans AdminisVation Form 20-5455 Tax Abatemeni Certificate'
E. ❑ Appliran[ is Ne surviving spouse of an indMdual who wouid have qualified for ihe deduction undet Nis section when he or she was el'rve.
(Age o/ deceased veteren on tlate W
�App6cant's a vetean of World War I.
�App6canPs service is evidenced by ❑ Letter from Veterans AdMnistration or Department � Defense; or
❑ Disrharge dowments
c. ❑ me assessed van,ason (a� 100%) of u,e p�operry tw wtix3, a,e aedumon rs aarned (rnay riot eacem szos,50Q) 5—
D. Q The pmpelty is fhe appG�anPs pr'vidpal resi0ence.
E. OThe app6rant wmed ihe pmpejty (w wds 6uying it ��r antrac� for at least one year befofe Ne date ot ihis app6cafbn.
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