Veterans_Stephens.,
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APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
W1M VETERANS AND SURVMNG SPOUSES OF CERTAIN VETERANS
State Fortn 72662 (R9 / SOB)
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Prescnbed by the Department of Local Govemment Fnance
��UCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one box may 6e checked; however, a surviving
spouse who receives a deduction under Section IV may not receive a deduction unde� Section 11.)
FILING DATES:
REAL PROPERTY: DURING THE �2 MONTHS BEFORE JUNE11 OF THE YEAR THE DEDUCTION Y.
MOBILE HOMES (6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR W C E DIVI U L ES TO
OBTAIN THE DEDUCTION.
[� I Totally disableC veteran (or veteran a( least age 62 vnlh at leas! 10% disa6ility) or surviving spouse - Not to exceed 512,�
Complete sections I. V and VI. (IC 6-7.7-72-74) APR 2 8 2008
❑ il Panially service-connected disabled veteran OR surviving spouse - Not t
Complete sections 11, V and VI. (IC 6-1.7-72-13) �
❑ 111 Wodd War I Veteran - Not to ezceed 578720
Complete seciions III, V and VL QC 6-1.7-72-17.4)
❑ IV Surviving spouse of Worid War I Vete2n - Noi to exceed 578.720
sections IV. V, and VI, pC 6-1.1-12-1
524,960
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GIBSON COUNTY AUDITOR
Name of apP � nt (first, mid e, last)
Add streetarrdnum r, cify�C D� e) r J�r_I O Co ty
J —/ DO
Applicant ( dces I does not ) own pmperty vrith another individual(s) besides spo arM/or anothe� veteren.
This application is made for the purpose of obtaining E deduction from the assessed valuation of the following descnbed taxable
for the
town,
s the property in question: Par i or
❑ Real Property ❑ Mobile Home (IC 61.7-7) �J ��
App6mnt was a member of ihe U.S. fvmed ForcES fa af least 90 days (riot neoes,urily dunrg war time�
B. 0 MPGrant v.as honorahy disdiarged.
. o?4a-(JO%
C. � Macard is: ❑ Totaily disaded; a
❑ At least age 62 with a[ least 10% disability
D. ❑ ApplinnPs disabifrty is evidenced hy ❑ Certi(rate W e6gibtlity from the Indiana DepaMrent ot Veterans Affairs;
❑ Pensim cerUficate:
❑ Avraid of canpensa6m hom Vaterans Administration or Departrnent of De(mse: or
❑ Veterans AdministraUOn Form 2P�5455'Tax Abatement Certificate'
E �� The assessed valualion (al 700Y ) of ihe property fa which the deducUm is daimed (may rrot ezceed 8173.000) S
F. � Appficant is ttie wrvivuig spouse of an individual who would have qualified fa the deduction under this section when he w she was alive.
(Age o/deceased Heteran on date aI deatl� )
A � Applicant was a member ot the U.S. Artned Forces during any of its wars.
B. ❑ Applicani was honorably discharged.
C. � Applipnl has a service-connected disability of at 10%
D. � Applicant's disability is evidenced by ertificate ot eligibility from the Indiana Departrnent of Veterans ARairs;
❑ Pension certificate;
❑ Award of mmpensation from Veterans Administration or Oepariment of Defense; or
❑ Veterans Administration Fortn 20-5455'Tax Abatement CeNficate'
E. � Applicant is Ihe surviving spouse of an indivi�iiial whn wniil�i havP qualfied for ihe dedudion under this seCtion when he or she was alive.
(Age o( deceased veferan on date o! death )
ilpplimnl is a veterm� af Wvld War I.
App(karrt's disabdity is eviderxxd by ❑ Letter ftmi Veterans AdministraUOn a Depamm.nt d Defense: or
❑ Disdiarge doamenis
C. ❑ The assessed vahiation (at 100°6) of the property for which the deduction is daimed (may rrot exceed 8 f 63,000) 3
D. O The property is ihe appdKarrt's p6idpal resbence.
E. 0 The ap�'xzrrt owned tlre property (or xas 6uy'ug it ur� car6acl) for at least me year before ihe date of this appticaGm.