HomeMy WebLinkAboutVeterans_BeadlesI rt�p�
��:_
�.,.
APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
INWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
State Form 12662 (R8 / 4-04)
Prescribed by the Depariment ot Local Govemment Finance
# � a
INSTRUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one box may be checked; however, a surviving
spouse who receives a deduction unde� Section IV may not receive a deduction under Section Il.)
�VG DATES:
REAL PROPERTY: DURING THE 12 MONTHS BEFORE MAY 11 OF THE YEAR THE DEDUCTIO� FFF¢¢¢ LY.��''''11 ��
MOBILE HOMES (6-1.1•7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR l�J��H IND�UP( WI`$HES TO
OBTAIN THE DEDUCTION. 1, � J
❑ I Totally disabled veteran (or veteran at leasf age 62 witFi at least f0% disabilityJ or surviving spouse - Not to exceed 512,480
Complete sec6ons I, V and VI. (IC 6-1.1-12-14) JUN 1 2 2006
I`� II Partially serviceconnected disabled veteran OR surviving spouse
Complete sections II, V and VI. (IC G1.1-72-13)
❑ III World War I Veteran - Not to exceed 518,720
Complete sections III. V and VL (IC 6-1.1-72-17.4)
❑ IV Surviving spouse of WoAd War I Veteran - Not to exceed 578,720
N, V, and VI. (IC 6-1.
Not to exceed 324,960
�� ��
GIBSON COUNTY AUDITOR
Name of applicant (first midd/e, last) Date o( birth (month, day, year)
Address (street d number, city, te, ZIP code) O ' �` ` Counry
Applicant ( does I does not ) own property with another individual(s) besides spouse andlor another veteran.
This applicatlon is made for the purpose o( obtaining S 1��� deducUon trom the assessed valuation of the following desaibed taxable
y (or the year 20S
District (ciry, town,
Is the property in question: Parcel or Ke number
❑ Real Property ❑ Mobile Home (IC 6-1.7-7) �— ����3 7��
.J AppGCant was a member of the U.S. Artned Fwces fw at least 90 days (rrot necessanty during wai fime).
B. O Applicant was honorebly discharged.
C. � AppGCant is: � TotaOy dsabled; or
❑ At least age 62 with at least 10%disability
D. ❑ Applipni's disabiliry is evidenced by ❑ Cerlifipte of eligibility from the Indiana Department of Veterans Affairs;
❑ Pension certifipte;
❑ Award of compensation Gom Veterans Administration w Departrnent of Defense; or
❑ Veterans AdministraGon Fortn 20.5455'Tax Abatemenl Certificate'
E. � The assessed valuation (at �00%) o( the properry for which the deduqion is daimed (may not exceed 5773,000) $
F. � AppGcant is the surv'rving spouse of an indrvidual who vrould have qualified (w the deduction urWer this seUion when he or she was alive.
(Age of deceased veteran on date ol death )
A. ❑ Appliwnt was a member of the U.S. Armed Forces during any of its wars.
B. � Applicant was honorably discharged.
C. � Applicant has a service-conneaed disability o( at least 10%
D. � ApplicanCs disability is evidenced by: ertificate of eligibility from the Indiana Department of Veterens Afiairs;
Pension certifcate;
❑ Award of wmpensaGon trom Veterans AdminisUation or Department o( Defense; or
❑ Veterans AdministraGon Fortn 20.5455'Tax Abatement Certificate'
E. 0 Applicanl is the surviving spouse of an individual who would have qualified for the deduction under this sectlon when he or she was alive.
(Age o/deceased veteran on date o/deafh )
A Ll Appppnt is a veteran ot World War I.
AppGpnPs disabiGry is evidenced by ❑ Letter from Veterans Administratirn or Department of Defense; a
❑ Discharge dowments
C. ❑ The assessed valua6on (at 100%,) of the pmperty for which ihe deducfion is daimed (maynot exceed 5763,000) $_
D. ❑ The property is the applipnCs principal residence.
E. � The applipnt ormed ihe property (a was buyirg d under contrac� (or at least one year betore the date of Gds application.