HomeMy WebLinkAboutVeterans_BurnsForm Number 12A - Revised 19�I!
Prescribed by State Board of Tax Commissioners /�/�/� ,/�
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' VETERANS, OR THEIR WIDOWS, STATEMENT OF SERVICE-CONNECTED DISABILITY �l d
IC 6-1. 1-12-13 and 6-1. 1-12-15 �q �G -`'` o� o
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That this application is made for the purpose of obtaining $�v v v
.
(not to exceed two thousand dollars) deduction from the assessed valu-
ation of the following described taxable property for the year 19 �OZ
to wit: �����
TAXING DISTRICT
LEGAL DESCRIPTION OR KEY NUMBER I�'��`�`^'� �jy"� '
That, in addition to the above amount of $ deduction applied
for in this County, (s)'he has or intends to apply for $ deduction
in County, Taxing District.
X p� � a.�.-�.
(Applicant/Guardian)
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�_ Subscribed and sworn to before me, and disab�t� �eri� is 1
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da y o f _�/,Zit !1( , 19 (�o� r.� _
MAR 1 1982 �
Auditor `
�a �'1ilJG1��
r,.� �nITOR _