HomeMy WebLinkAboutVeterans_Miller"'^ APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERAN$�'� ��
_ � 1NWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETER�N��
.. Stala Form 72fi62 (Rt1 / 70-08) JL g
�S Prewibed by lha OepaAmenl d Laal Gwemment Firenm q
N j� DB !1 U.y-���-���
STRUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one box m�y c evc,ked; however, a surviving
spouse who receives a deductlon under Section IV may not receive a deduction unde� Se 'c;k \' V
FILING DATES: `" ��'��
REAL PROPERTY: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT. R
MOBILE HOMES (IC 6-1.1-7) OR MANUFACTURED HOMES NOT ASSESSED AS REAL PROPE �JN�?'ik1�L��` 12) MONTHS
BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE� CTION.
� I Totalty disa6led vete2n (or veteran at leasf age 62 with at least f09; disability) or surv'rving spouse - Not�572.4&1
Complete sections I, V and VL (IC 6-1.1-12-14)
� II Partially service-connected disabted veteran OR survrvinB spouse - Not to exceed 524,�
ComD�ete sections II, V and VI. (IC 61.'I-12-13)
❑ 111 WoAd War I Veteran - Not lo exceed 518,720
Complele sectbns ill, V and VI. QC 61.1-12-17.4J
❑ N Surviving spouse ot Wor1d War I Vete2n - Not to exceed 578,72(1
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Complete sections N, V, antl VI. (IC 61.1-12-16)
Name of appGrant (first, mMdle, las�
dress (s6eet and number, aty, sfate, arid ZIP code) County
3/ R SLE . C � S
Applicant Qdces Qfoes not ) own property vrith another individual(s) besiEes spause antllor another veteran.
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This application is made for the purpose o( obtaining Sa7 � T TU• -� deduction from the assessed valuation ot the (dbwing described t�abie
praperty fw the year 20
Ta�drg District (city, town, township) Is the property in questlon: Parcel w Key numbw p
❑ Real PropeM ❑ Mobile Hwne (IC 6-1.1-7) ��� — — �Q� •6a% O �� �
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�App&aM wds a manber d fhe U.S. ArtneE Forces for at least 90 days (rtet necessanly dunng wertime).
8. � APP6can[ was FqnaadY dischaiged.
C.� App6[aM a: ❑ TofaAy disabled: ar
� At least age 62 with at la3st 10% disabiGty
D. �AppGranCs d�saWLty is evidenced by ❑ Certfirate of d'gi6ility (rom ihe Indiana Deparhnent of Veterans Aftairs;
❑ Pension certfinte:
- ,� Award ot compensatlm fran Veterans Pdministratim or Department of Defense: or
❑ Vete2ns AdrttinisVatbn Fortn 20.5455 Taz Abatement Certifirate'
E Q The assessed valuation (at 100%) oF Ne property (or wNcn U�e deduUion is daimed (may rrot exceed $143,160) 3
F. QAppG[ant is the survivinc� spouse of an udividual who would have qualified fw the deduction under iha section v+hen he w she was alive.
(Age d deceased veteran on date d deeth )
. . .
A� Applicant was a member of the U.S. Armed Forces during any of its vrars.
B. � Applirant was honorably discharged.
C. � Applinnt has a seMce wnneGed disability of at least 10q
D. �Applicant's disabiliry is evitlenced by ❑ Certifin;e of eligibiliry from Ne I�iana Department of Veterans Aftairs;
❑ Pension certificate;
,�Award of compensafion from Veterans Adminisvation w Departrnent of Defense; or
❑ Veterens Administratirn Fortn 20-5455 Tax Abatement Certificate'
E. ❑ Appiicant is Me surv'rving spouse ot an individuai who would have qualified for the deduction under ihis seabn when he w she was alive.
(Age oldeceasetl vete�an on date d death )
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A❑App5rant is a ve'san of WoM War I.
B. ❑App&anPs service is evider�ced by: ❑ Letter from Veterans Adrtdnatration a Department � Defense; a
❑ D'adwge tlocuments
�. Q rna asse,ssed van,aeon (at'loo°,6) of a,e vroae�v ror wtva, u,e deducfim is aaimed (rnay nof ezceeo szos,soa) s
D. Q The pmpuly is ihe appG�anl's pruripal rc4daice.
E. QThe app6rant oxned the pmpefty (or Kas buy"u�g it'vMe� an6ecQ tar at least rne year b�ore Me date of ih"s app&atio2
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