HomeMy WebLinkAboutVeterans_Glover"'� APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, � I��� B�
� 1NWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS �L� ���
-� Slata Fwm 1266T (RN / 70O8J FEB :1 `5.2012
S Prasfribed by lhe Deparimerd of Local Govemment Firianca
�TRUCTIONS: Please check appropriafe box(es) pertainirn� to tax deduction. (Moie lhan one box may be cherJ�d;�h we�✓ r .a surviving
� spouse wiro receives a deduc6on under Section IV may not receive a dedudion under SecSon YfJ ��"` _ V
FILING DATES:
REAL PROPERTY: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT. �,Igg(�N�N��Y�p���S
MOBILE HOMES (IC 6-1.1-7) OR MANUFACTURED HOMES NOTASSESSED AS REAL PROPERTY: DURI G T E �[7
BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DEDUCTION.
� I Totalty disabled veteran (or vete�sn at least age 62 wifh at least f0% disa6ifity) or survivirg spouse - Not d 572.480
Complete sections I, V antl VL (IC 6-1.1-12-14)
� II Partialy serriceconnected disaWed veteran OR surv"rving spouse - Not to exceed 524,960
Compiete sections II, V and VI. (IC f.1.1-12-13)
❑ 111 World War I Veteren - Not to exceed 518.720
Complete sectlons �II, V and VI. (IC C>7.1-12-17.4)
❑ N Surviving spouse of Worid War I Veteran - Not to exceed 518,720
Complete sections N, V, and VI. (IC 61.
Name oi applicant (first,
and
Applicant Qdoes Qfoes not ) own property with another individual(s) besides spouse and/or another veteran.
�YZr/'-' �/ �'�e/
� �
��
G�85aN
This appliwtion is made for the purpose o( obtaining S� T%�O �. v deductian from the assessed ratuation of the fdbwing tlescribed tasable
property fw the year
Is the pmperty in question: rarcei or ney numoer /J
❑ Real Property ❑ Mobile Hwne (IC 6-1.1-7) ly'�(J'/�_�(%U - l%G��! ����
'�,� Ap�Gcarit xas a member of fhe U.S. Artned Forces for at least 90 days (�rot necsssanN.�r��>•^,•'°. `""'� -�
tl. ❑ MP6cant v.as honorabty dischar9ed. �� .
C. ❑ ApPfrant Ls: ❑ TofaAy d�sabkd: w -G // �� ^
❑ At least age 62 vrifh at I�st 10% disad6ty
D. Q App6pnt's disabsty's e�ridenced by: ❑ Certikate of eJigibiiiry hom the InGians uepartrnent of Veterans Affairs;
❑ Pension mrtifirate:
❑ Avrard of oomPensation Uom Veterans ldrtunistration or Departmerd of D�ense; or
❑ Veterans Administration Form 2a5455 Tax Abatemrnl Certifirate
E. ❑ me assessed vah,amn (at loox) or the poperty ror whia, a,e aeaucmn is aamea (mey �rot exceed S1s3,1 so� s
F. ❑ Mp��� 4s the survivinc� spouse of an uMividual who xould have qualified for the deduction under ihis section when he w she was alive.
(Age ddeceased veteian on date d death )
/I
- U
A� App6cant was a member of Ihe U.S. Armed Forces during any of its wars.
B. � Applirant was hrnoraby discharged.
C. � Applicant has a service conneCed disaGlityrro�pf11at least 10%
D. �AppGCant's disabifity is evidenced by � Cxrtifrcate of eligibility from the IiMiana Department ot Ve[erans Aftairs;
Pension certifirate;
❑ Award ot compensa6on from Veterans Adminishation or Department of Defense; or
❑ Veterans Administration Form 20.5455 "Tax Abatement Certificate
E. ❑ Appliw�i is the wrv'rving spouse ot an individual who would have qualfied for the deduaion under this section when he w she was alive.
(Age ol deceased vefe�an on date
A❑/1ppGcant is a veteran oi World War I.
B. QApplicaM's serira is evidenced by: ❑ Letter hom Veterans A�rtrinistration or Deparimenf d Defense; or
❑ Diu3wge dowments
F ❑ me assessea van,anwi (ac �oo^�) of a�e croperry ror wbd, me aedua«, is aaimed (rney no� aeceed szos.soai s—
,ri. ❑ The pmperty is �he apPfrant's pr'v�a� fe9dence.
E. ❑The app6mnt wmed the pmperty (w was 6uy"ag it iaMer oorrtracQ tor at least one year before fhe date ot a� app&ation.