HomeMy WebLinkAboutVeterans_Wilkerson�' , APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, ��� ��
i;'�'� :• i; . WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERA �
s� o Sute Fartn 12662 (R8 / 4-0a)
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Prescribed by the Depanment of Local Govemment Finance
JUN 1 g p007
INSTRUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one box may ber�,hecked; however, a surviving
spouse who receives a deduction under Section IV may not 2ceive a deduction under Se� � y
REA PRO ERTY: DURING THE 12 MONTHS BEFORE MAY 11 OF THE YEAR THE DEDUCTION 1��R1iP�NTy AU��t7
MOBILE HOMES (6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR WHICH THE INDIVIDUAL W�FiES TO
OBTAIN THE DEDUCTION.
❑ I Tot disabled veteran (or veteran at least age 62 with at least f0% disability) or surviving spouse - Not lo exceed 512,480
mplete sections I, V and VI. (IC 6-1.7-12-14)
II Partially service-connected disabled veteren OR surviving spouse - Not to exceed 524,960 -
Complete sections il, V and VL (IC 6-7.1-12-13)
� III Wor1d War I Veteran - Not to exceed $18,720
Compiete sections III, V and VI. (IC 6-1.1-12-17.4)
❑ IV Surviving spouse o( Worid War I Veteran - Not to exceed 578,720
- Complete sections N, V, and VI. (IC 6-1.1-12-i6)
Name of applicant ( t, ' dle, last)
Address (street and number, cit st , IP code) �
U�
Applicant oes does not ) own property with another individual(s) besides spouse andlor another veleren.
This application is made for the purpose o( obtaining S�' /�� deduc6on from the assessed valuation o( the following described Wuable
pmperty for the year 20_
pis i lown, to ns ') Is e property in quesiion: Parcel or Key number (, /�/�/�
r eal Property ❑ Mobile Home QC 6-1.1-7) a6� —% 3—�Q`/� L/�/
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� Appficant was a member of the U.S. Artned Fwces fa at least 90 days (not necessanty dunng war time).
B. ❑ Apptipnt was honoraby discharged.
C. � AppGcant is: ❑ TotaOy disabled; or
❑ At least age 62 vriN at least 10°/, disability
D. � ApplicanPs disability is evidenced by ❑ Cerlificate of eligibility (rom the Indiana Department of Veterans Affairs;
� ❑ Pension ceNficate;
❑ Award of compensation trom Vetemns Administration w Oepartment of Defense; or
❑ Veterans Administratbn Fortn 20.5455'Tax Abatement Certificate'
E. ❑ The assessed wah�ation (at 100%) of the property for which ihe deduction is daimed (may rrot exceed $173,000) $
F. 0 Applicant is Ne surviving spouse of an individual who would have qualified for the deduction under this section when he or she was alive.
(Age of deceased vete2n on date ot death )
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A. A�plicant was a member of lhe U.S. Armed Forces during any of its wars.
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B. �^ A�pp icant was honorably discharged.
C. �nt has a serviceconnected disabiliry of at lea 10%
D. pplicanl's disability is evidenced by: ertifirate of eligibility fmm the Indiana Department of Veterens Aftairs;
❑ Pension certi(cate:
❑ Award of compensation from Veterans Adminisvation or Department of Defense: or
❑ Veterans Administration Form 20-5455'Tax Abatement Certificate'
E. ❑ Applicant is lhe surviving spouse of an individual who wovld have qualified for the deduction under this secUon when he or she was alive.
(Age o! deceased veteran on date oldeath )
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A❑ Applicant is a veteran of World War I.
��� AppliranCs disabiGty is evidenced by: ❑ Letter from Veterans Administratlon or Departrnent of Defense; or
❑ Discharge documents
C. 0 The assessed valuation (at 100%) of the property for which the deductlon is daimed (may not exceed 3163,000) 3
D. ❑ The properry is the applicanYs prindpal residence.
E. ❑ The applicant avned the pmperry (or was buyirg d under contract) tor at least one year befwe the date of tFus apptiption.
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