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HomeMy WebLinkAboutVeterans_Holder�>> APPLICATION FOR PROPERTY TAX BENEFITS FOR DISABLED VETERANS 1s AND SURVIVING SPOUSES OF CERTAIN VETERANS '' State Form 12662 (R20 / 6-26 ae ) Prescribed by the Department of Local Government Finance Instructions: Please check appropriate box(es) pertaining to the applicable tax deduction or credit. More than one (1) box may be checked, however, an individual who claims a deduction under Section I may not claim a credit under Section 11 or Section 111 or a deduction under Section V for that same assessment date. (IC 6-1.1-12-14(d); IC 6-1.1-12-14.5(d)) t-mng Date: This form must be completed, signed, and filed by January 15 of the calendar year in which the property taxes are first due and payable. File with the Bounty auditor of the county where the property is located. C�j/ Totally Disabled Veteran or Surviving Spouse — Deduction of 100% of the assessed value of principal place of residence Complete Sections 1, VI, and Vll. (IC 6-1.1-12-14) ❑ II Veteran with Service -Connected Disability or Surviving Spouse — Credit not to exceed $350 Complete Sections ll, Vl, and VII. (IC 6-1.1-51.3-6) ❑ III Veteran at least Age 62 with at least 10% Disability or Surviving Spouse — Credit not to exceed $250 Complete Sections III, VI, and VII. (IC 6-1.1-51.3-5) ❑ IV Surviving Spouse of World War I Veteran — Deduction not to exceed $18,720 Complete Sections IV, VI, and Vll. (IC 6-1.1-12-16) ❑ V Deduction for Homestead Donated to Veteran Complete Sections V, VI, and VII. (IC 6-1.1-12-14.5) APPLICANT INFORMATION Name of Applicant (first, middle, last) Date of Birth (month, day, year) Telephone Number Holder, Arletta M l+p —� �� t�--� - l _ ��U9 Address (number and street, city, state, and ZIP code) County Email Address 7888 E 300 S Oakland City, IN 47660 Gibson Applicant (❑ does ❑ does not) own property with another individual(s) besides spouse and/or another veteran. This application is made for the purpose of obtaining $ deduction from the assessed valuation of the following described taxable property and/or $ credit against local property taxes imposed on the following described taxable property for the year 20 (If applicant desires that a credit be split among additional properties, list those properties on additional sheet and attach it to this application. The deductions under Section I and Section V may only apply to the applicant's homestead property.) Taxing District (city, town, townships) Is the property in question: Parcel or Key Number .nter M Real Property ❑ Mobile Home (IC 6-1.1-7) 26-13-28-100-000.283-004 A. ❑ Applicant served in the military or naval forces of the United States for at least ninety (90) days (not necessarily during war time). B. ❑ Applicant was honorably discharged. C. ❑ Applicant has a total disability. D. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility (Section VIII) from the Indiana Department of Veterans Affairs ("IDVA") after IDVA has determined that the individual's disability qualifies the individual to receive a deduction under IC 6- 1.1-12-14; ❑ Pension certificate from the U.S. Department of Veterans Affairs; or ❑ Award of compensation from U.S. Department of Veterans Affairs E. ❑ Applicant has resided in Indiana for at least one (1) year before the assessment date for which this deduction is claimed. F. ❑ Applicant is the surviving spouse of an individual who would have qualified for the deduction under this section when he or she was alive and the applicant has not subsequently remarried. G. ❑ Applicant uses the property on which the deduction is claimed as the applicant's homestead (principal place of residence). A veteran who claims this deduction for an assessment date may not also claim the Homestead Donated to Veteran Deduction under IC 6-1.1-12- 14.5 or receive a local Pro= tax credit under IC 6-1.1-51.3 for that same assessment date. A. ❑ Applicant served in the military or naval forces of the United States during any of its wars. B. ❑ Applicant was honorably discharged. C. ❑ Applicant has a service -connected disability of at least 10% or more. D. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility (Section VIII) from the Indiana Department of Veterans Affairs ("IDVA") after IDVA has determined that the individual's disability qualifies the individual to receive a credit under IC 6-1.1- 51.3-6; ❑ Pension certificate from the U.S. Department of Veterans Affairs; or -� n Awnrril of r--n—tinn nr.J;c k nh. Page 1 of 2 SECTION III —VETERAN AT LEAST AGE 62 WITH DISABILITY OF 10% OR MORE CREDIT A. ❑ Applicant served in the military or naval forces of the United States for at least ninety (90) days (not necessarily during war time). B. ❑ Applicant was honorably discharged. C. ❑ Applicant is at least age 62 with at least 10% disability. —Q ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility (Section VIII) from the Indiana Department of Veterans Affairs ("IDVA") after IDVA has determined that the individual's disability qualifies the individual to receive a deduction under IC 6- 1.1-12-14; ❑ Pension certificate from the U.S. Department of Veterans Affairs; or ❑ Award of compensation from U.S. Department of Veterans Affairs E. ❑ Applicant is the surviving spouse of an individual who: (1) would have qualified for the credit under this section when he or she was alive; or (2) was killed in action, died while serving on active duty, or died while performing inactive duty training. (Age of deceased veteran on date of death ) SECTION-• OF WORLDA. ❑ Applicant is the surviving spouse of an individual who served in the military or naval forces of the United States before November 12, 1918. B. ❑ The service of the deceased spouse is evidence by: ❑ Letter from the U.S. Department of Veterans Affairs; or ❑ Honorable discharge documents C. ❑ The deceased spouse received an honorable discharge. SECTION V — DEDUCTION FOR HOMESTEAD DONATED TO VETERAN A. ❑ Applicant served in the military or naval forces of the United States for at least ninety (90) days. B. ❑ Applicant was honorably discharged. C. ❑ Applicant has a disability of at least 50%. D. ❑ Applicant's disability is evidenced by: ❑ Pension certificate or an award of compensation issued by the U.S. Department of Veterans Affairs; or ❑ A certificate of eligibility (Section VIII) issued to the individual by the Indiana Department of Veterans' Affairs ("IDVA") after IDVA has determined that the individual's disability qualifies the individual to receive a deduction under IC 6-1.1-12-14.5 E. ❑ Applicant's homestead was conveyed without charge to the applicant who is the owner of the homestead by an organization that is exempt from income taxation under the federal Internal Revenue Code. The amount of the deduction is determined as follows: 1. If the applicant is totally disabled, the deduction is equal to 100% of the assessed value of the homestead. 2. If the applicant has a disability of at least 90% but is not totally disabled, the deduction is equal to 90% of the assessed value of the homestead. 3. If the applicant has a disability of at least 80% but less than 90%, the deduction is equal to 80% of the assessed value of the homestead. 4. If the applicant has a disability of at least 70% but less than 80%, the deduction is equal to 70% of the assessed value of the homestead. 5. If the applicant has a disability of at least 60% but less than 70%, the deduction is equal to 60% of the assessed value of the homestead. 6. If the applicant has a disability of at least 50% but less than 60%, the deduction is equal to 50% of the assessed value of the homestead. veteran who claims this deduction for an assessment date may not also claim the Totally Disabled Veteran Deduction under IC 6-1.1-12-14 for 'at same assessment date. Moreover, an unused portion of this deduction may NOT be applied to excise taxes. SECTIOND. • •- • A. ❑ Applicant owns the property on which the deduction or credit is claimed or is buying it under contract that provides that the applicant is to pay the property taxes, which contract, or a memorandum of the contract, is recorded in the County Recorder's office. Record Number Page (Note that a person applying for a deduction under Section V must own the property.) B. ❑ Applicant has applied or intends to apply for one or more of these credits on other property in this county or in another county. ❑ Yes ❑ No Amount $ County Taxing District Second County Taxing District SECTION• - • • SIGNATURE I certify that this application was filed in my office. Date Filed (month, day, year) I certify that the information provided in this application is true and correct. The intentional inclusion of false information on this form is a criminal violation under IC 6-1.1-37-3 or -4. SigR�e of Count A�jtor Signatur f Applicant or Legal Representative Name of County Auditor(typedor written) �1 n I Michael A Watkins • • •- . • • Vetes Military Service Veteran's character of discharge C More than ninety (90) days Q norable or Under Honorable Conditions veteran's a of service (check one) VA disability rating Veteran's date of birth (month, day, year) El Wa Me service Peacetime service , 1�, L4 l Accredited IDVA staff or a cre 'te ana, my Veteran Serpiqb Officer signature Date (month, day, year) 00 Page 2 of 2 ' "'" APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, ��� � WINI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS �� .�. � Stale Form 1266T (R71 / 76OB) ��� ,. Prescnbad by the Department of loal Gwemmen� Finante iNSTRUCTIONS: Please check appropriate box(es) peRainirn� to tax deduction. (More fhan one 6ox may be chec�{dLh6lv�e6rd Surviving spouse wiro receives a deducGon under Section IV may not receive a deduction under Section 11.) [ U I I FILING DATES: C. �. REAL PROPERN: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT. MOBILE HOMES (IC 6-1.1-7) OR MANUFACTURED HOMES NOT ASSESSED AS REAL PROPERTY: DUFj,IjJG THE TWEL ( MONTHS BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DEDUCi9t4#SON COUNTY q�DITOR � I Tofalty disabletl veteran (or veteian af leasf age 62 with at least f0% disability) or surviving spous 512.480 Cwnplete sections I, V and VI. (IC 6-1.1-12-14) � II Partially serviceconnected Aisabled veteran OR survrving spouse - Not to exceed 524,96� Compiete sectlons II, V and VI. (IC 6-1.1-12-13) j ❑ III Wafd War I Veleren - Not to excced 518.720 � Complele sectlons III, V and VL (IC G7.1-12-17.4) � ❑ N Surviving spouse ot Worid War I Veteran - Not to exceed $18,720 � � Complete sections N, V, and VL (IC 61.1-12-16) Name of applirant (first, middle, lasf) A dress (sheet and num6er, dty; state, and ZIP code) County 0 S. L S `r` D � 0 Applicant Odoes Qdaes not ) own property vrith another individual(s) besides spouse and/or another veteren. This application is made for the purpose of obtaining S �� /� deduction from lhe assessed valuatlon of the fdbwing described tazable property far the year 20_ Ta�drg Di ric[ (ci town, townsliip) Is t�e property in Question: Pam.el or Key nu^m1ber � Real Pmperty ❑ Mobile Home (IC 6-1.1-7) p� —I ' of � IOO �� a g� � - - � . . � .. � • . �. .- . . �. ��. . ��� AppGqnt �ras a member of the U.S. Artned Fwces for at least 90 days (rrot necessanfy dunng wer time). B. �App6rant vras honarady discharged. C. [� Appticard's: � TotaOy disabled; or ❑ At least age 62 with at la3st 10% disabitiy O.�AppfcanYs dsabdity a e�ridesced by � Cerlifirata of eJigi6ility fran the Intliana Department aF Vete2ns ARtirs; ❑ Pension ceAifirate: ❑ Award ot canpensatim Uom Veterans Pdrtmiishation or DepartmeM of Defense: w ❑ Veterans Adrttinistration Fartn 20.5455 Tar Abatesnmt Certifitate' E. ❑ The assrssed vaWation (at 10096) of Ne property for whid� ihe deduction is damed (mey rra' exceed $143,160� 4 ���Appfrant is the wrvivc�g spouse of an uWrvidual wha would have quatified for the deduction under iha sectiori when he or she was alive. (Age ddemased veleran on date d deeth���? � ) ' . . . . A. Applicant was a member of the U.S. Artned Forces durirg any of its wars. B. Applicant was honwably discharged. C. Applipnt has a service wnnected disabiliry of ai leasi 10N D. � AppGcanYs disability is evidenced by � Certifirate ot eligibiliry from the Indiana Department of Veterans Aftairs; ❑ Pension certifi�ate; ❑ Avrdrd of compensation irom Vererans Administration a Departrnent of Defense; or ❑ Veterans Adminis;retion Form 20-5455 "Tax Aba.ement Certficate E�Appllcant is the survrving spouse of an individual who would have qualified for ihe deduc[ion under this section when he w she was alive. (Age of deceesed veferan on Oate W deafh_�'� ) . A❑AppGcant s a vetsan a( World N'ar I. B. ❑App6canPs service is evidenced hy ❑ Le[ter Gom Veterans Adrtmiatration or Departm�t d Defense; w � ❑ Disdwge documents �. ❑ The assessetl valua0on (at 100%) of tlie pmperty fw wtixh ihe deduc4m is dairt�d (may not ezceed 8206,50� S D. Q The pmperty is the appGCanCs pr"vrcipal residence. E. ❑The appEcant amed the propaty (a uas 6uyrt�g it �r conNac� for at least rne year befofe the date of ihis apptication • � • � '