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Home My WebLink AboutVeterans_Emge_ rt.i� S �« APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, WWI VETERANS AND SURVIVIiJG SPbUSES OF CERTAIN VETERANS State Form 12662 (R7 / 6-03) PrescriEed by the Oeparonent of Local Govemment Finance �"RUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one box may be checked; however, a surviving spouse who receives a deduction under Secfion IV may not receive a deduction under Section ll.) FILING DATES: REAL PROPERTY: DURING THE t2 MONTHS BEFORE MAY 11 OF THE YEAR THE DEDUCTION IS TO APPLY. MOBILE HOMES (6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DEDUCTION. Name ot Address ❑ I Totally disabled veteran (or veteran at least age 62 wifh atleast 70% disabilify) w surviving�s1pouse - Not to'eaccee!�d-56y,�000 Complete sections I, V and VL (IC 6-1.1-12-14) �� y g� ❑ II Partially service-connected disabled veteran OR surviving spouse - Not to exceed $]�L,000 �'� Complete sections II, V and VI. (IC 6-1.7-72-13) ❑ III WoAd War 1 Veteran - Not to exceed $9,000 Complete sections III, V and VI. (IC 6-1.7-12-77.4) ❑ IV Surviving spouse oi Wortd War I Veteran - Not to exceed 59,000 and ComO�ete sectio�s IV, V, and VI. (IC 6-1.1-12•16) YRT...^..'� Appiicant ( does I does not ) own property with another individual(s) besides spouse and/or anoNer veteren. NOV i 0 2003 � �-��-,�. � o�� r This application is made for the purpose of obtaining $� ai �� deduction trom the assessed valuation of e tollowing escn ed taxa e nrooertv tor the vear 2� �. ' C� fown, township) Is the perty in queslion: Parcel or Key ary-�—t; eal Property ❑ Mobile Home QC 6-1.1-7) �n , Applicant was a member of Me U.S. Armed Forces for at least 90 days (no[ necessaidy dunrg war tene). B. ❑ Applinnt vras honorably disdiarged. C. � Applicant is: ❑ TotaDy disabled: w ❑ At leas[ age 62 with at least 10% disability D. ❑ ApplicanPs disabtliry is evidenced by ❑ Certif�cate of eligibiliry from the Indiana Departrnent of Veterans Nfairs; ❑ Pensirn cerGfinte; ❑ AHard of compensation from Veterans Administrauon or Department of Defense; or ❑ Veterans Administra6on Fortn 20.5455 `fa�c Abatement Certifipte' E. � The assessed valuation (at 100%) of the property (or which the deduction is daimed (mey rrof ezceed $113,000) $ F. � Applipnt is tha wrvrv'uig spouse of an individual vfio would have quatfied fw the dedumon under this sectlon when he w she was alive. (Age oldeceased veteran on date of death ) A. t� Applipnt was a member of the U.S. Artned Forces during any ot its wars. B. ^' Applipni was honorably tlischargetl. C. �pplicant has a service-connected disabiliry of at least 10% D. ❑ Applicant's disabiliry is evidenced by: Q� Certificate of eligibiliry from the Indiana Department of Veterans AKairs; lY'Pension certificate; ❑ Award of compensatlon from Veterans AdminisVation or Department of Defense; or ❑ Veterans Administretlon Fortn 20.5455'Tax Ahatement CertiLrate' E. CJ Applicant is the surviving spouse of an individual who would have qualified for the deduction under this section when he or she was alive. (Age o/deceased veteran on date o/ death ) Appiicant is a veteran of Worltl War I. ApplicanPs disabldy is evidenced by ❑ Letter fmm Veterans Administrafion w Department of Defense; or ❑ Dis�harge documents C. � The assessed valuation (at 700%) of Me properry for whidi the dedu�on is daimed (may not exceed S 163,000) 5_ D. � The pmperty is the applicanfs prindpal residence. E. � The appficant owned the properry (or was buyirg d urrder contract) fw at least one year before the date of lhis aDPlication. n SECTION IV-DEDUCTION FOR HOMESTEAD DONATED TO VETERAN .1. Applicant served in the military or naval forces of the United States for at least ninety(90)days; • 2. Applicant received an honorable discharge; 3. Applicant has a disability of at least 50%; 4. Applicant's disability is evidenced by: a pension certificate or an award of compensation issued by the United States Department of Veterans Affairs;or 0a certificate of eligibility 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 urider this new er of the statue; a stead by an organization that is exempt from nd 5. Applicant's homestead was conveyed without charge to the applicant 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 the individual 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. an deduction or dA veteran eduction under IC 6-1.1'12-13 ori14,f respectively,for that same assessment date.or an assessment date may not also claim a pMo el Moreover,anlun sedrportion of this deduct only lmay NOT sabled veteran be applied to excise taxes(See the Veteran Deduction Worksheet portion of this form.). SECTION V - ADDITIONAL INFORMATION A.❑ Applicant owns the property on which the deduction is claimed or is buying it under contract that provides that the appl icant is to pay the property taxes,which contract,or a memorandum of the contract,is recorded in the County Recorder's orde Record number page (Note that a person applyingfor a deduction under Section IV must own the property.) B.0 Applicant has applied or intends to apply for one or more of these deductions on other property in this county or in another county. ❑ Yes ❑ No Amount$ Taxing district County Taxing district Second county SECTION VI - APPLICATION VERIFICATION AND AUDITOR SIGNATURE I certify that this application was filed in my office. I certify that the information provided in this application is true and Date filed(month,day,year) correct.The intentional inclusion of false information on this form is Signature of county auditor a criminal violation under IC 6-1.1-37-3 or 4. Name of county auditor(typed or written) Sign:t -of applicant or I�- representative VETERAN DEDUCTION WORKSHEET 20 20 20 1. Total disability($12,480) 2. Partial disability($24,960) 3. WWI surviving spouse($18,720)(Cannot be claimed in conjunction with the totally disabled veteran deduction.) n be 4. Homestedl can towns;canntot be claimedo vetern ainconjunction plied only to homestead applicant with partial disability or total disability deductions.) 5. Total deduction available(add lines 1, 2,3,and 4) 6. Amount applied to real estate key number 7. Amount applied to personal property duplicate number 8. Amount applied to mobile home duplicate number 9. Total deduction applied to taxable property(add lines 6, 7,and 8) 10. Deduction available for excise*(subtract line 9 from line 5) 11. Excise credit ). For *;vehicles,the unused portion of theit vete aontn deductionoreduc s the aannual exc se tax in the amount ofxtwo dollars($2 00)on eachmotor theVehicle or Aircraft License one hundred dollars($100.00)of taxable value or major portion thereof. For aircraft,the credit equals the amount of the unused portion of the veteran deduction multiplied by 0.07. However, unused portion of deduction for donated homestead may not be applied toward excise taxes. For more information,see IC 6-6-5-5 and IC 6-6-6.5-13. _ .• FILED • w" .l DEPARTMENT OF VETERANS AFFAIRS At t/ CERTIFICATE OF ELIGIBILITY ,II IL 302 West Washington St. DISABLED VETERAN TAX DEDUCTIuni 1 5 2019 Indianapolis,IN 46204-2738 State Form 51186(R5/11-13) Telephone:(317)232-3910 _ Fax:(317)232-7721 *