HomeMy WebLinkAboutVeterans_Boedeker"'" APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
� WINI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
- Stale Form 12662 (R77 /10-0BJ
�' �� Prewibed by the Deparimerit d Loml Govemment Financa
.STRUCTIONS: Please check appropriate box(es) pertainirn� to tax deduction. (More fhan one box may be checked; however, a surviving
spouse wlro receives a deduc6on under Section IV may not �eceive a deduction under Sec6on 11.)
FILING DATES:
REAL PROPERTY: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT. �
MOBILE HOMES (IC 6-1.1-7) OR MANUFACTURED HOMES NOT ASSESSEDAS REAL PROPERTY: DURING THE TWELVE (12) MONTHS
BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DEDUCTION.
� I To�alty disabled veteran (or vetelan af least age 62 with at leasl f 0% disability) or surviving spouse - Not to e�cc�ed 812,4&1
Canplete sections I, V and VL (IC 6-1.1-12-14)
❑ II Partially service-connecfetl disabled vetersn OR surv'rving spouse - Not to exceed 524,960
Compiete sections II, V and VL (IC Gtbt2-13)
❑ III WoAd War I Veteren - Not to exceed 518,720
Complete sections 111, V and VI. (IC 61.1-12-17.4)
❑ N Surviving spouse ot Wortd War I Veteran - Not to exceed 518,720
Complete sections N, V, and VI. (IC 61.1-12-16)
Name of applicant (first, middle, la
Ad ress(streetandnum6er,dty,state,andZlPcode Caunty
S T: SoN .�%. b� Q c,n �N �� o � 6�0
Applirant Qdces a'!ces not ) own property with another indivitlual(s) besides spouse aM/or another veteran.
p� cy'
This applicalion is made for Ne puryose oi obtaining S �� � Q � deduction from the assessed rdluation of ihe fdbwing described taxable
I
property fw the year 20_
Taxing DLstrict (city, fown, township) Is the property in Questbn: P or y n ber
❑ Real Pmperty ❑ Mobile Home (IC 6-1.7-7 :,v �J� .
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.� AppGcant wds a member af Me U.S. Artned Forces for at IPast 90 days (rrof newssan7y durv�g trar6me�
B. Q MP6cant was honoraMY dischaf9ed.
G[Y� ApplicaM is: ❑ TotaOy d�sabletl; or
❑ At least age 62 with at I�si 10% dsabiGty
D. �.AppGranYs di96diy ¢ evidenced M' �Certificata af tligibitity from Ihe Ind"ana DepaN��nt of Veterans Affairs;
❑ Pension certfirate;
❑ Awdrd of mmpansaGm fran Veterans AdmmisUation w DePartmeM o( De`ense: w
❑ Vete+ans Administration Fortn 2a5455 "Tax Abatament Certifirate'
E� The assessed valuation (at 100%) of �he property (w wltirh Ne deduction 6 ciaimed (may rrot exceed 5743,160� S
F. AppGcant is ihe survrvvig spouse of an uid'widual o xwld have qualified fw fhe deduction under ihis section when he or she was alive.
(Age d deoeased �steran ar date d deeth
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A Q Applicant was a member of the U.S. Artned Forces during any of its wars.
B. � Applicant was honwahty disrharged.
C. Q Applinnt has a service wnneGed disabiliry of ai least 10%
D. ❑ ApplicanYs disability is evidenced hy ❑ Certificafi of eligibiliry frwn the Indiana Department of Veterans Aftairs;
❑ Pension certificate;
❑ Awaid of compensaiion from Veterans Administration or Department of Defer�se; w
❑ Veterens Administration Fortn 20-5455 Tax Abatement Certificate'
E. ❑ Applirant is Me survrving spouse of an individual who would have qualified far the dedudion under this section when he a she was elive.
(Age o! deceesed veteren on dafe o/ deafh ) .
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A QApp5cant's a vetrsan of WorW War I.
B. QApp6canYs service "s evidenced by ❑ Letter from Ve[erare Admmistration v Depar6nent of Defaise; a
❑ D¢t�harge doaimenis
❑ The assessea �ran,ation (at too°F,) of ine properry tor wnich me tledudi«, is atimed (rriay not axceed 82o6,soo� S
D. O The pmperry is the app6nnPs prc�a� msidence.
E. Qme app5cant wmed me pmpary (w xas bu�m,g ir ivMer canbac� tor at least me year be`ora the date of ma appkxtiort "
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