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Veterans_Olson.., � f S ♦ ,.w APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, YVWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS Slate Fwm 12662 (R6 / 10.01) Prescribed by Ne Department o( Local Govemrtrent Finance �� . � c• -. � /: 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 under Section IV may not 2ceive a deduction under Section ll.) G DATES: REAL PROPERTY: DURING THE 12 MONTHS BEFORE MAY 11 OF THE YEAR THE DEDUCTION IS TO APPLY. MOBILE HOMES (6-7.1-7): BETWEEN JANUARY 15 AMD MARCH 31 OF THE YEAR THE DEDUCTION IS TO BE EFFECTIVE. ❑ I Totally disabled veteran (or veleran atleast age 62 with at leasf f0% disability) or surviving spouse - Not to exceed 56,000 Compfete sections I, V and VI. (IC 6-1.7-12-14) ❑ II Partially service-conneCed disabled veteran OR surviving spouse - Not to exceed 512,000 Complele sections II, V and Vi. QC 6-1.7-12-13) ❑ III World War I Veteran - Not to exceed 59,000 Complete sections III, V and VI. (IC 6-1.1-12-77.4) ❑ IV Surviving spouse of World War I Veteren - Not to exceed 89,000 Complete seclions N, V, and VI. (IC 61.1-12-1 Zip code ( does / does not ) own property with another individual(s) besides spouse and/or another veteran. applipGon is made for the purpose of obtaining forthe township) APP(rord deduction from the s the property in question: ❑ Real Property ❑ Mobile Home (IC 6-1.1 Mned Forces for at least 90 days (not necessany dunrg B. ❑ Appii�ant was hono2bly d�arged. C. � AppGpnt is: ❑ TotaDy disabled; or ❑ At least age 62 with at least 70°h disabiliry 1 Date of birth (monfh, day, yea�j oi . �um� 5 ; :i3 �,,5 - o� D. � AppluanYs disaWlity is evidenred by ❑ Certificate of eligibility 6om the IrWiana Department of Veterans Aftairs; ❑ Pensioyn certificate; - � qw�ot compensation from Veterans Administration or Departrrent of Defense; or ���: ��rans Administration Fortn 20.5455 "Tau Abatement CeRifipte' E. ❑ The assessed vaWation (at 700°�) of the property for which the deduption is daimed (may not ezceed $54,OOOj $ ' a "� F. ❑ Appfipnt is the surviving spouse of an vWividual who xrould have qualified tw the dedurtion under ihis section when he or she was alive. (Age o/c�ceased veteren on date ol death ) A. ❑ Applicant was a member of the U.S. Artned Forces during any of its wars. taxable B. � Applicant was honorably discharged. C. � Appiicant has a servicetanneGed disability of at least 10% D. ❑ ApplicanYS disability is evidenced by: ❑ Ce�cate of eligibiliry 6om the Indiana Departrnent of Veterans Affairs; ❑ Pensio rtificate; ❑ A rd of compensation hom Veterans Administration or Departrnent of Defense; or eteraris Administration Fortn 20.5455'Tau Abatement CeAifipte' E. O Applipnt is the survrving spouse of an individual who wouid have qualified for the deductlon under this section when he or she was aiive. (Age o/deceased veteran on date of �+PG�rd is a veteran � App6pnPs disab�ity is evidena�d by ❑ Letter from Veterans Administration or Departrnent of Defense; or ❑ Discharge documents C. � The assessed valuation (at 100°�) of the properry for which the deducalion is davned (may rat exoeed 578,000) $ D. O The property is the appficanPs principal residence. - E � The app&2rd ovmed the property (a wss buyirg it under conGacQ fir al least one year before the date of this applirafion. _