HomeMy WebLinkAboutVeterans_Owens°'° APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
- WINI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS ��% .
SWte Fwm 12662 (R6 / 10.01) �
S��. f Presrribed by Ihe Department of Local Govemment Finance
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�RUCTIONS: Please check appropriate boz(es) pertaining to tax deduction. (MO2 than one box may be checked; however, a surviving
spouse who receives a deduction under Section IV may not receive a deduction under Secfion II.J
G DATES:
REAL PROPERTY: DURING THE 12 MONTHS BEFORE MAY 11 OF THE YEAR THE DEDUCTION IS T�P�CY.� ` i�
MOBILE HOMES (6-1.1-7): BETWEEN JANUARY 15 AND MARCH 31 OF TFiE YEAR THE DEDUCTION 0 E FFEC7WE.
❑ I Totally disabled veteran (o� veteran af (east age 62 with al least 70Y disabifity) or survivin9 spo se - t to 7eteed
Complete sections I, V and VI. (IC G7.1-12-14)
�II Partially service-connected disabled veteran OR survrving spouse - Not to exceed 512,000
Complete sedions II, V and VI. (IC 6-1.1-72-13)
� III Wodd War I Veteran - Not to exceed $9,000
Complete seaions III, V and VI. (IC 6-7.1-12-17.4)
❑ IV Surviving spouse of World War I Veteren - Not to ezceed $9,000
�rk 17 2003
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Complele seGions N, V, and VI. (IC 6-1.1-12-16)
Name of applicant (first, middle, las�
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Addr ss (st2ef arM number, city and state) Zip code Couny
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Appiipnt ( dces / oes not own property with another individual(s) besides spouse andlor anoMer veteren.
This application is made for the purpose of obtaining $�� CJ U U deduction from the assessed valuation of the folowing described taxable
property, for Ne year 20 ��J .
Taxing DistriG (dty, town, township) Is the property in question: Parcel or Key number
��� [j�eal Property ❑ Mobile Home (IC 6-1.1-7) �QO' : _. ���y-_�,
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App�icarrt was a member of ihe U.S. Arrned Forrns for at least 90 days (not necessariy dunrg ivar time).
B. ❑ P,pp6nnt was honarably d�arged.
C. ❑ AppGpnt s: ❑ Totaly disabled; or
❑ At least age 62 with at least 10% disabiliry
D. � ApplzanPs disabdity is evidenred by ❑ Certfipte of el'gibitity 6om the Indiana DeparVrient of Vete2n5 Aftairs;
❑ Pension certificate;
❑ Award ot compensation 6om Veterans Administration or Departrnent of De(ense; or
❑ Veterans Admin'stration Form 20.5455 "Tax Abatement Certifipte'
E. ❑ The assesud rdWation (at 100°�) of the property for whitli the deduntion is da'ured (may rat exceed $54,000) $
F. ❑ ApplipM is the survivirg spouse of an "uMividual who would have qualified for ihe dedurtion under this seUion when he or she was alive.
(Age of deoeased veteran rn date ofdeath )
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A. Applipnt was a member of the U.S. Artned Forces during any of its wars.
B. o�,�/,q�ptinnt was honorably discharged.
C. ld Applicant has a service�onnected disability of at least 10°h
D. ❑ ApplicanYs disability is evidenced by: ❑ Certifipte of eligibility from the Indiana Departrnent of Veterans Affairs;
❑ Pension certificate;
O Award of compensa5on from Veterans Administration or Departrnent of De(ense; or
�/eterans Administration Form 20.5455'Tax Abatement Certfipte'
E. ❑ Applicant is ihe surviving spouse o( an individual who would have qualified for the deduction under this sec6on when he or she was alive.
(A9e of deceased veteranon date oldeath ) •
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��❑ App6caM is a vete2n ot World War L �
� ApptipnYs disabildy is evidenoed by ❑ Letter from Veterans PdminisVation or Departrnent of Defense; or
❑ Disdiarge documents
C. ❑ The assessed vaNatbn (at 100°,6) of the property for whith the deducation is daured (may not exceed 578,000) S
D. ❑ The properry is ihe applinnYs prindpal residence.
E. � The app&aM amed the property (or �ds buyirg d under oontracry for at least one year before fhe date of this application. .
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