HomeMy WebLinkAboutVeterans_Bilderback (3)"'^ APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
1NWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
State Form 72662 (R71 ! 10-O8J
� �� � Prescribed by Ihe Deperimertl af L.o�l Gwamment Finance
�TRUCTIONS: Please check appropriate box(es) pertainirn� to tax deduction. (More than one box may be checked; however, a surviving
spouse who receives a deduc6on under Section IV may not receive a deduclion under Section 11.)
FILING DATES:
REAL PROPERTY: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT.
MOBILE HOMES (IC E1.1-7) OR MANUFACTURED HOMES NOTASSESSED AS REAL PR0QQ ���ERTY: DURING THE TWELVE (12) MONTHS
BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN�D�D TIO� �
❑ I Totally disabled vete2n (or vete�an at least age 62 witb at least f0% disa6ifity) a urviv u No t 512,480
Canplete sections I, V antl VL (IC 6-1.1-12-14)
Partialry service�connected tlisabled vete2n OR surviving spouse - Not to exceed 524,�T f C 20 f�
Complete secoons II, V and VI. (IC E1.'I-12-13) �� �� �
❑ 111 World War I Veleran - Not fo exceed 516.720
Canpleta sections 111, V and VI. (IC 61.1-12-17.4)
❑ N Surviving spouse of Wortd War I Vateran - Nof to axceed 518,720
Complete sections N, V, and VI. (IC G1.1-12-
Name of applicant (first, middle,
C .'�. n��
GIBSON COUNTY AUDITOR
Applicant Odces dfoes not ) own praperty with another individual(s) besides spouse antllor another veteran.
This application is matle for the purpose oi obtaining S� 7 �LrJ� deductlon from lhe assessed valuatlon of the following tlescrihed tazable
property fw the year 20
is ihe property in question:
❑ Real Pmperry ❑ Mobile Home (IC 6-1.1-7)
0 / -CYSI.OIS-
F❑ AavG�t was a manber d me us. amea Forces ror a� �east Bo dan (� �awssany durmg war6n�e).
tl. ❑ App&ant was honorady dischatged.
C. ❑ App6card "s: ❑ TotaOy d'isabled: or
❑ At least age 62 with at I�si 10%disabiGty
D. Q App6qnYs d�sabdty 6 e�riderced by ❑ Certikate M d'9iblGry irom Ne Ind'ana Deparlment of Veterans Affairs;
❑ Pension certifirate:
❑ Awerd ot compensatim Gom Veterans Administration or Department o( Defense; w
❑ Veterans Adrtunistratbn Fortn 20.5455 Taz Abatsn�t Certificate'
E. ❑ The assessed �aluation (af 100%) oF Me property for wlrirh the deduction is daimed (may irof exceed 8143,160� S
F. �AppGcan� is �he siwiving spouse of an mdividual who would have qualified fw ihe deducfio� under this section when he ar she vrds alive.
(Age ddeceased veteran on date d death )
A Q Applicant was a member of the U.S. Nmed Forces duri� any of its wars.
B. 0 Applicant was honwably discharged.
C.� Applicant has a seMce connected disabiliry of at least 10%
D. ❑ AppGCant's d'isabifity is evidenced by �Certikate of eligibiliry from the IiMiana Department of Ve[uans Aftairs;
�❑ Pension certfirate;
❑ Award of compensation frwn Veterans AdminisVation w Departrnent of Defense; or
❑ Veterans Administration Form 20-5455 "Tax Abatement Certificate'
E. 0 Applirant is the wrviving spouse of an indNidual who would have qualified for the deduction under ihis sectan when he w she was alive.
(Age W deceasetl veteran on date o! death )
A❑!Wp&ant is a veteJar� of WoM War I.
B. ❑App6caM's servim is evidenced by ❑ Letter Gom Veterans Adrtcnatration or Deparfinen� d Defense; w
❑ Oisc�harge dowments
C■ ❑ The assessed vaNation (at 100%) of ihe property for wttirh the detlutlim's daimed (may not ezceetl 5206.5001 $_
ID. ❑ The pmperiy's Ne app&anl's pr'vv�al resEence.
E. ❑The app6ant owned the pmperiy (w �rds 6uying it'alder cm6acQ for at least one year bwore the date ot iha appfication