HomeMy WebLinkAboutVeterans_Grau"` ��" APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
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' WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS �`
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� ���� State Form 72662 (R8 / 4-0a)
Prescribed by the Department of Local Gwemment Finance
STRUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one 6ox may be check d; however, a surviving
spouse who receives a deduction unde� Section IV may not receive a deduction under Section ll.)
�NG DATES:
REAL PROPERTY: DURING THE 12 MONTHS BEFORE MAY 11 OF THE YEAR THE DEDUCTION IS TO APPLY.
A10BILE HOMES (6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO
OBTAIN THE DEDUCTION.
❑ I Totally disabled veteran (or veleran at least age 62 with at least 70% disabilityJ or survivirn�eyeysqp. to e�5�;d�
Complete sections I, V and VI. QC 6-1.1-12-14) �j--1 q 9 d
�Partialty serviceconnected disabled veteran OR surv'rving spouse - Not to exceed 524,9601L � JL!
Complete sectlons II, V and VI. (IC 6-1.1-72-13)
❑ III World War I Veteran - Not to exceed $18,720 JAN 0 2 2007 .
Complete seclions III, V and VI. (IC 6-7.1-12-17.4)
❑ IV Surviving spouse of World War I Veteran - Not to exceed 578,720 �7„6� � v
Complete sections N, V, and VI. (IC &1.1-12-16) �� �� �} U�
Name of applicant ((rst, mid ,
Address (street and number, ciry, state, ZIP code) ��� �
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Applicant ( does / does not � own property with another individual(s) besides spouse and/or another veteran.
This application is made (or the purpose o( obtaining � d€d ti� frotn e assessed valuaUon of the tollovring desaibed taxable
property tor the year 20 '%- ,,Z ,Z -� a� 3 OQ ' D 0�, a� a- a�`(
Ta�cing District (city, town, township) Is the property in queslion: Parc�r K y number
❑ Real Property ❑ Mobile Home QC 6•t.i-7) —O��as- �—, �
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� AppGrdnt �ras a member of fhe U.S. Armed Forces for at least 90 days (not necessanly during war time).
B. � Applirant was hono2bly discharged.
C. � Appliqnt is: Totally diubled; or
� least age 62 with at least 10°/, disability
D. 0 Apptinnfs disaM7ity is e�enced by. ❑ Certifipte of eligibiliry Gom the Indiana Oepartrnenf af Veterens Aftairs;
❑ Pension certificate;
❑ Award of compensation from Veterans Administration or Department of De(ense; or
❑ Veterans Adm'uustration Form 20.5455 Tax Abatement Certificate'
E. ❑ The assessed valuation (at 100%) of ihe property for which the deduction is da"uned (may not exceed 5773,000) 5
F. ❑ Appliwnt is the surv'rving spouse o( an individual who vrould have qualified (or the deduction under this section when he a she vras alive.
(Age o/deceased vete2n on date oJ.death_ )
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A 0 Applicant was a member of Ihe U.S. Armed Forces during any of its wars.
B. � Applicant was honorably discharged.
C.�pplicant has a service-connected disabiliry ot at least 10°/,
D. ❑ Applicant's disabiiity is evidenced by: ❑ Certificate of eligibility from the Indiana Department of Veterans AHairs;
❑ Pension certificate;
[�wartl of compensatlon from Veterans Administration or Department o( Defense; or
❑ Veterens AdministraGon Form 20-5455'Tax Abatement Certificate'
E. ❑ Applican[ is the surv'rving spouse of an individual who would have qualified for lhe deduclion under this section when he or she was alive.
(Age o/deceased veteran on date of death 1
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A � Appiicant is a vete2n of World War I. •• ,
�� ApplicanYs disabifiry is evidenced by: ❑ Letter from Veterans Adminisiratirn or Department of De(ense; or
❑ Dis�harge documenLs
C. ❑ The assessed vatua6on (at t00qo) o( the properly for which the deduction is daimed (maynot ezceed 5763,000) S
D. 0 The property is the applicanCs prinapal residence. .
E. 0 The applicant ovmed ihe property (or was buying if urMer contract) for at least one year before fhe date of this application.
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