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Home My WebLink AboutVeterans_Smith (9)�, , . a � 4w APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, YVWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS State Form 12662 (R6 / 10.01) Prescribed by Ihe Department of Local Govemment Finance � INSTRUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (Mo2 than one box may 6e checked; however, a surviving spouse who receives a deduction under Section IV may not receive a deductio under Section ll.) �NG DATES: ary MOBILE OMES (6-1� 17): BETWEEN JANUARY 15�AR1D MARCH 31 OF TNE YEAR THE D DU�N.I�L T. PLY.�� p� ❑ I Totaiy disabled veteran (or veteran at Ieast age 62 with af least 70% disability) or surviving spquge� Npa [o eyke�ea 56,000 Complete sedions I, V and VL (IC 67.1-12-14) f C U 5 1u � ❑ II Partialy service-conneGed disabled veteran OR surviving spouse - Not to exceed 512 D Complete sections II, V and VL QC 6-1.7-12-13) ❑ III Wodd War I Veteren - Nol to exceed 59,000 � GIBSON OUN7 Y AUDITOR Complete seCions III, V and VI. (IC 6-7.7-12-17.4) U fV Complete seGions N, V, a d VI.V(ICra�;-'N12 t76)zceed 59,000 �/�— O `� r� /-� C T (l V Name of appiipnt (first, middle, las� �,� � �' [ Address (sfreet and numbe � and state) Zi Coun � � — � a i Appliwnt ( tloes I does not ) own property with another individual(s) besides spouse and/or another veteran. This application is�r7�de r the urpose of obtaining $ dedudion from the assessed valuation of the tolowing described tazable P�aPeNY. rthe�3 0 0� . T'ng rs'd (eAy, town, wnship) Is lh property in question: Parcei or Key.number- Real Property ❑ Mobile Home pC 6-7.1-7) - -- ��G � . . � .. •' ..• �•. � Appfinnt was a member of the U.S. Artred Foroes tor at least 90 days (not necessa�7y dunng war time). B. � Applirant was honoraby discharged. C.�Apptirant is: �Totatly disabled; or ❑ At least age 62 wilh at least 10°h disabiliry D. ❑ ApplitanYs disabd4y's evidenced by ❑ Certfinte of eligibilily from the Indiana Departmenl of Vete2ns Aftairs; ❑ Pensbn certifirate; ❑ Award of oompensation 6om Veterans Administration or Departrnent of Defense; or ❑ Veterens Adrtdnistration Form 20.5455 "Tax Abatement Certifipte' E. ❑ The assessed vah�afion (at 700°�) of the properry for whirh the dedu�ation is daimed (may nat exceed $54,000� $ F. ❑ App6pnt is the surv"rving spouse of an individual who would have qualified for ihe dedudion under this section when he or she was alive. � (Age o7deceased veteren on date o/deafh 1 • . � .. A. ❑ Applipnt was a member of the U.S. Armed Forces during any of its wars. B. � Applicant was honorably discharged. C. ❑ Applicant has a serviceconneded disability of at least 70°h D. ❑ Applicanfs disability is evidenced by: ❑ Certificate of eligibiliry from the Indiana Departrnent of Veterans Affairs; ❑ Pension certificate; ❑ Award of compensation from Veterans AdminisUa6on or Department of Defense; or ❑ Veterans Administration Fortn 20.5455 "Tax Abatement Certificate' E. � Applipnt is the surviving spouse of an individual who would have qualified for the deductio� under this section when he or she was alive. , (Ageo/deceasedveteran�ondateofdeath ) • r�k • . . � A❑ Appficarrt is a veteran of World War I. ApplicanYs disabilily is evidenoed by: ❑ Letter from Veterans PdminisVatbn or Departrrent of Defense; or ❑ Dscharge documenis C. � The asussed valuation (at 100°�) of the propeAy tor which the deduretion is dam�ed (may not ezceed S78,OOQ) S D. ❑ The property is the appGn�rt's prindpal residence. E. 0 The appGnnt owned the property (a was buyirg d urder con6ac� for at least one year before the date of this application. • � • �