HomeMy WebLinkAboutVeterans_Veatch.' �," e.��"'^o APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS �J �% �
--� WWI VETERANS AND SURVtVING SPOUSES OF CERTAIN VETERANS �Ff
s^ - `. _
�..,s_: '•• Sia[e Form 12662 (R411-00) ^y g�
�� Prescribed by the State Board of Tax Commissioners "��J--�{ Hp �� �
INSTRUCTIONS: Please check appropriate box(es) pertaining to tau deduction. (Mor�tha �e box may be checked; however, a -
surviving spouse who receives a deduction under Section IV may not rec��,e de�c��'�nder Section II.)
HI U
THIS APPLICATION MUST BE FILED DURING THE 12 MONTHS BEFORE MAY 11 OF E YEAR THE OEDUCTIION IS TO APPLY.
❑ I Totally disabled veteran (or veteran at leas( age 62 with at least 10% disabi' r s i �� e�4�LY�eed 52,000
Complete sections I, V and VL pC 6-1.1-72-14) �,�gSON COU�7Y AUDITOR ,
❑ II Partialty service-connected disabled veteran OR surviving spouse - Not to ezceed 54,000
Complete sections II, V and VI. (IC 6-1.7-12-13)
❑ III Wodd War I Veteran - Not to exceed 53,000
Complete sections III, V and VI. (IC 6-1.7-12-77.4)
u IV Surviving spouse of Wodd War I Veteran - Not to exceed 53,000
Complete sections IV, V and VL pC 6-1.1-12-16)
Name o l st mid /ast -^_�
�
A d t et umbei cy"�'/\a s t C Zip code t/�� County .
�� • LJ ��� . � .. � �J�O f -... �� / _. ����
Applicant ( does / dces not ) own property with another individual(s) besides spouse and/or another veteran.
�
This application is made for the purpose ot obtaining 5 �D oD - deduction from the assessed valuation of the following described
taxable property for the year 20� ,O I � m
i w
Ta " �sirict (ci town, township) Parcel o y Nu er '� � �,�,� `�
�Or'1 cQb� "-b-% 3=-3 =�a ...,'
,, • . . � .. •' ..- . �•. . ..
A. � Applicant was a member of the U.S. Artned Forces for at least 90 days (not necessanty dunng wai time).
B. � Applicani was honorably discharged.
C. ❑ Applirant is ❑ Totally disabled: or
❑ At least age 62 wiih at leasi 10 % disabiliry
D. ❑�Applicant's disability is evidenced by: � Certificate of eligibiliry from the Indiana Department of Veterans Aflairs;
❑ Pension certiticate: .
❑ Award of compensation from Veterans Administration or Departmen� of Defense; or
❑ Veterans Administration Form 20-5455 "Tax Abatemeni Certificate"
E. ❑ The assessed valuation of ihe properry tor which ihe deduction is claimed (may not exceed 518,000) $
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 o7 deceased veteran on date o7 deafh ) -
• � ..
A. i Applicant was a member of the U.S. Armed Forces during any of its wars.
B. �.Applicant was honorably discharged.
C. �Applicant is has a service-connecied disabiliry of ai least 70%. �
D. C� Applicani's disability is evidenced by: ❑ Certificate of eligibiliry from the Indiana Department of Veterans Attairs;
❑ Pension certificate;
❑ Award of compensation from Veterens Administration or Department of Defense; or
❑ Veterans Administration Form 20-5455 "Tax Abatement Certificate"
E. ❑ Applicani is the surviving spouse of an individual who would have qualified for [he deduction under this section when he or she was alive
(Age of deceased veteran on date o! death 1
• • .
� O Applicant is a veteran of Wodd War I. , .
-�B. ❑ Applicant's disability is evidenced by: ❑ Letter from Veterans Administration or Department of Defense: or �.
❑ Discharge documents
C. ❑ 7he assessed valuation of the property for which the deduction is claimed (may not exceed 526,000) S
D. ❑ The property is the applicant's principal resitlence. •`
E. � The applicani owned the property (or was buying if undei contract) for at least one year betore the date of ihis application.
� � • �
. . _ - - =— - _ � �-- _,�_- r - - - -�-'--. .J; - -