HomeMy WebLinkAboutVeterans_McIntosh�" APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
� WWI VETERANS AND SURVMNG SPOUSES OF CERTAIN VE�NS
,«. J�• Slate Fortn 12662 (fi9 / SOB) �
Prewibed 6y the Departmem ot Loral Govemmen[ Finarrcx
�RUCTIONS: Piease check appropriate box(es) pertaining to tax deduction. (Mo�e than one box may be ch�;.�er, a surviving
spouse who receives a deduction under Section IV may not receive a deduction u r�ecSe,Ftion 11.)
FILING DATES: �" � I 2(�08
REAL PROPERTY: DURING THE 12 MONTHS BEFORE JUNE11 OF THE YEAR THE DEDUCTION IS TO APPLY
MOBILE HOMES (6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR WI�iI�Fi THE INDIVIDUAL WISHES TO
OBTAIN THE DEDUCTION. �a"• .Q�
GIBgt� Q
❑ I Totally disa6led veteran (or veteran at least age 62 wi[h af least f0% disabilityJ or surn�l�� sp6U4b7qlo,ti(Q�cERd 512,480
Complete sections I, V and VL (IC 6-7J-72-14) e
❑ II Partially service-connected disabled veteran OR surviving spouse - Not to exceed 524,960 �
Complete sections II, V and VL (IC 6-1.1-tt-73)
❑ III Wortd War 1 Veteran - Not to exceed 578,720 ��� 3
Complete seaions III, V and VI. QC 6-7.1-72-77.4) ��
❑ IV Surviving spouse of Wor1d War I Veteran - Not to exceed 578.720
Complete sections IV, V, and VL QC 6-1.1-12•�6)
Name of applicant (first, middle, last)
s A. os �
Address (street and number, city, stafe, ZIP code) Counry .
S - 7CZ EE�" '4� �o! $So 4l
Applicant ( dces I does not ) own property with another individual(s) besides spouse and/or another veteran.
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This applicalion is made for the purpose of obfaining $��'i��%. — deduction from Ihe assessed valuation of the following described taxable
propeny for the year 20_ �
Taxing District (dry, town, township) Is the property in questlon: Pa I or Key number ,f �i
❑ Reai Property ❑ Mobile Home (IC 6-1.1-7) . 3�– D� DUO• � C/4
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A� Appfirant �vas a member of tlie U.S. Nmed Forces fa al least 90 days (rat necessardy dunrg war tvrie�
B. ,� App6rant was honorably disdwged.
C. � Appficant is: ❑ Totapy disaded; a ..
,� Al leasi age 62 with a[ ieasl 70% disabdiry
D. � Appli�anCs disabifrty is e�ridenced by .� CeNficate d e6gibdity Gom ihe Indiana Deparbnent o( Vete2ns Affavs;
❑ Pereim tzr�fxate:
❑ Award of canpensalion hom Veterans Administration or Departrnent ot Defense: or
❑ Veterans Administratlon Form 20.Si55 "iax Abatement Cemfirate'
E❑ The aswsseA vahiatim (at 700%) of fhe pmperty for whidi the deduction is daimed (mey not ezceed 5773.000) S
F.� Applipnt is tlie survhmig spouse of an irdividual who would have quafified fa tl�e deducbrn under ihis section when he ar she xas alive.
�(Age of deceased �eteran on date W dearii ��%�)
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A� Applicant was a member ot the U.S. Artned Fwces during any o( its wars. �
B. � Applirani was honorably discharged.
C. � Applicant has a service�connected disabiliry of at least 10%
D. � ApplicanYs disabiliry is evidenced by: I�, Certifica[e of eligibiliry from ihe Indiana Departrnent of Velerans Aftairs;
❑ Pension certificate;
❑ Award of compensalim hom Veterans AdminisVation or Department of Detense; or
❑ Veterens Adminislratian Fortn 2o-5455'Tax Abatement CeNficate'
E. � Applicant is ihe surviving spouse of an indiviAi�al whn wrn�lA havn qualified tor tlie deduction under this section when he or she was alive.�
(Age of deceased veteran on date d death %� )
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r] �carri is a veteran of Wafd War I.
� Appfi�arri's disa�ry is evidenced by: ❑ Letter from Veterans AdministraUOn or Deparm�errt d Defense; or
❑ Disdiargedocuments
C. � The assessed valuatbn (at 100%) W the property for x?u�h fhe deducUOn is davned (may rrof ezceed $ 763,000) S
D. � The P�P�Y s Ne appGcarrt's p"v�dpal residence. �
E. � The appfuant wmed Uie propesty (w wds buyirg it urrder oontr-acf) for at kast one year befwe ihe date of this appGration.
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