HomeMy WebLinkAboutVeterans_Newcomei��rt�" , APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
'°. ;: 1NWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS � � �
�o � State Fortn 72662 (R8 / 4-04)
Prescdbed by the Depanment of Local Govemmem Finance
INSTRUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one box may be checked; however, a surviving
spouse who receives a deducfion under Section IV may not receive a deduction under Section Il.)
NG DATES:
REAL PROPERN: DURING THE 12 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 YEA��TI��qL WISHES TO
OBTAIN THE DEDUCTION.
❑ I Totally disabled veteran (or veteran at least age 62 with at least 70% disability) urvi e t d 512,480
Complete secUons I, V and VL QC 6-1.1-12-14)
�. II Partially service-connected disabled veteran OR surviving spouse - Not to exceed S24,�N G 1 s Z UU %
Complete sections II, V and VI. (IC 6-1.1-12-13)
❑ III Wodd War I Veteran - Not to exceed 518,720
Complete sections Iil, V and VI. (IC 6-1.7-12-�7.4)
❑ IV Surviving spouse o( World War I Veteren - Not to exceed 518,720
GIBSO�pUN�� ITOR
Complete sedions N, V, and VI. (IC 6-1.1-12-16)
Name of appli n(firs4 middfe, 1 t
Address (street nd number, ciry, state, ZI/P code�)1 ^ County �
� (O V
Applicant ( does / does not ) own property with another individual(s) besides spouse and/or another veteran.
This application is made (or the purpose oi obtaining 5 0� �i I �,�, � deductlon from the assessed valuaUon o( the following described taxable
property (or the year 20
'ng Distnct (city, town, township) Is the property in question: Parcel or Key number
�i4eal Property ❑ Mobile Home (IC 6-1.1-7) _ I -/O -3OO '�. �iy _ p a I
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AppGcant eras a member of ihe U.S. Fvmed Forces fa at least 90 days (rrot necessany dunng war fime).
B. ❑ APPlicant was Fiorro2bly dscharged.
C. ❑ P,pplicantis: ❑ TotaOydisabled:or
❑ At least age 62 vrith at least 70°/, disability
D. 0 ApptipnPs dsaMlity is evidenced by ❑ Certifipte of eligibiliry Gom the Indiana Department of Veterans Affairs;
❑ Pension certificate; � "
❑ Award of mmpensation hwn Vete2ns Administration w Department of Defense; or
❑ Veterans Administration Fortn 20.5455'Tax Abatement Certificate'
E. 0 The assessed valuation (at 100%) of ihe property for which ihe deduction is daimed (may not exceed $713,000) $
F. � Applicant is the surirving spouse of an individual who would have qualified for ihe deduction under iFtis sectio� when he or she was alive.
(Age of deceased veteran on date ol death )
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A. � Appiicant was a member of the U.S. Armed Forces during any of its wars.
8.,� Applicant was honorably discharged.
C. �Applicant has a service-connected disability of ai least 10% cZ O�
D. Applicanl's disability is evidenced by: �Certificate of eli9ibiliry hom the Indiana Deparimen[ of Veterans ARairs;
� ❑ Pension certificate;
❑ Awartl of compensaGon from Veterans Administration or Department of Defense; or
❑ Veterans Administrauon Form 20-5455'Tax Abatement Certificate'
E. � Applicant is the survrving spouse of an individual who would have qualified for the deduction under this section when he or she was alive.
(Age o/deceased veteren on date o7death )
• . .
A � Appliwnt is a veteran of World War I.
� ApptipnPs disabi6ry is evidenced by ❑ Letter from Veterans Admwstratlon or Department o( Defense; or
❑ Discharge documenLs �
C. � The assessed va�uation (at t 00Y,) of the pmperty for which the deducfion is daimed (may not exceed 3763,000) 5
D. 0 The property is the applipnYS prirkipal residence.
E. 0 The applicant amed the property (cv �ras buying d under contraU) for at leasi one year befwe Ihe date of this appGcation.
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