HomeMy WebLinkAboutVeterans_Owens.�•"'"4 APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS
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;, -�- ; WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
•>.... � � Siate Form 72662 (R4/1-00)
°' Prescribed by the State Board of Tax Commissioners
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INSTRUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one box m�be c�ec{red'-�wever, a
surviving spouse who receives a deduction under Section IV may not recew'�,5�det1duction unde� Section ll.)
THIS APPLICATION MUST BE FILED DURING THE 12 MONTHS BEFORE MAY 11 OF THE Y�AR THEAEUUE IT O�N�IS" O APPLY.
❑ I Totally disabled veteran (or veteran at least age 62 with at least 10% disability) or surviving 6�e� Notig g�ceed 52,000
Complete sections I, V and VI. (IC 6-1.7-12-14) �`
❑ II Partially service-wnnected disabied veteran OR surviving spouse — Not to exceed 54�00
Complete sections II, V and VI. (IC 6-1.7-72-13)
❑ III Wodd War I Veteran — Not to ezceed 53,000 GiggpN CO'J^!Tl' AUDITOR
Complete sections III, V and VL (IC 6-1.7-72-17.4)
❑ IV Surviving spouse of Wodd War I Veteran — Noi to exceed 53,000
Complete sections IV, V and VL QC 6-t.1-12-16)
Name of licant (firs .' dl t
Addr (str n number, ci and statel Zi code Counry •
Applicant ( does / dces nol ) own properry with another individual(s) besides spouse and/or another veteran.
This application is made for the purpose of obtaining S, '�• vv v deduction from the assessed valuation of the followinq described
taxable property for ihe year 20�_�_. � - � � � �� ' �
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Tauing District (city, town, townshr 1 Parc I or Nu er ' � r�`� : j' �'i
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A. O Applicant was a member of the U.S. Armed Forces for at least 90 days (not necessanly during war time).
B. ❑ Applicant was honorably discharged.
C. ❑ Applicant is ❑ Totally disabled: or
❑ At least age 62 with at least 70% disability
D. ❑ Applicant's disabiliry is evidenced by: ❑ Certificate of eligibility from the Indiana Department of Veterans AHairs;
❑ Pension certificate;
❑ Award oi compensation from Veterans Administration or Department of Defense; or
❑ Veterans Administration Form 20-5455 "Tax Abatement Certificate"
E. ❑ The assessed valuation of ihe property for which ihe deduction is claimed (may not exceed 518.000) 5
F. ❑ Applicant is ihe surviving spouse of an individual who would have qualified for the deduction under this seciion when he or she was alive.
(Age o/ deceased veteran on dafe o/ deafh )
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A. ❑ Applicani was a member of ihe U.S. Armed Forces during�any of its wars.
B. ❑ Applicani was honorably discharged.
C. ❑ Applicani is has a service-connected disability of east 10%.
D. ❑ ApplicanPS disability is evidenced by: Cl e'ficate of eligibiliry from the Indiana Department of Veterans Affairs;
C ension certificate;
❑ Award ol compensation tmm Veterans Administration or Department of Defense; or
❑ Veterans Adminisiration Form 20-5455 "Tax Abatement Certificate"
E. ❑ Applicant is Ihe surviving spouse of an individual who would have qualified tor ihe deduction under ihis section when he or she was alive
(Age o/ deceased veteran on date of death 1
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.❑ Applicani is a veteren of Worid War I.
B. ❑ ApplicanPS disabiliry is evidenced by: ❑ Letter trom Veterans Administration or Department of Defense; or '
❑ Discharge documents �' �
C. ❑ The assessed valuation of the property for which the deduction is claimed (may not exceed 526,000) 5 /
D. ❑ The property is Ihe applicanPs principal residence.
E. ❑ The applicant owned ihe property (o� was buying if unde� contract) for at least one year before the date of this application. ]
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