HomeMy WebLinkAboutVeterans_Hartwell"'" APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, %, j� I �,._Q
C._ � INWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS ,}y �P'
Stata Fwm 12662 (R11 I 1P-08) ,,i,
�,. , Prasvibad by Iha DepartmeM d Laal Govemment Finance �" - �
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�TRUCTIONS: Please check approprrate 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 YEAR FOR WHICH THE DEDUCTION IS SOUGHT.
MOBILE HOMES (IC 6-1.1-7) OR MANUFACTURED HOMES NOT ASSESSED AS REAL PROPERTY: DURING THE TVJELVE (12) MONTHS
BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DEDUCTION.
� I ToWlty disabled veteran (or veteran at leasf age 62 with at least f0% dwa6ility) or survrving spouse -��� �
Complete sections I, V antl VL (IC 6-1.1-12-14)
❑ I� Partially servicetonnected disaWed veteran OR surviving spouse - Nof to exceed 524,960
Completa sections II, V and VI. (IC Et.'I-12-13)
❑ 111 World War I Vefe2n - Not to exceed 518.720
Complete sectbns III, V and VI. (IC 67.1-12-17.4)
❑ N Surviving spouse of Wortd War I Veteran - Not to exceed 518.720
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Applirant Odoes dlces not ) own property with another individual(s) besides spouse and/or another veteran.
This appiication is made for the purpose of abtaining S v deduction from fhe assessed ralua6on of the fdbwing desuibed tazable
fw lhe year 20 �U
Is t e property in question: rarcei or
'�Real Pmperty ❑ Mobile Home (IC 6-1.1-7) G'�/
aao-oo�. 09�- ad-?
r❑.npp&ant vras a memcer ar me us. nrmed Forces tor at I�as� so days (nw nemssertiy dumy vrdr6me}
B. ❑ App6cant vras honaady dischaiged.
C.�App6car�'s: ❑TofaAydsabled:or
�At least age 62 with at I�st 10% disabifity
D. Q App6pnYs disabS�ty 6 e�ridenced by ❑ Certficate of eligibifity fram ihe Intliana Department of Vete2ns Afitirs;
❑ Pensimcertif�cale;
�Avrdrd of arnpensation fran Veterans Adrtrinistratim or DeparimeM of Defense; or
❑ Ve,e2ns Administration Fortn 20.5455 "�au Abatem�t Certficate'
E. Q me assessed van,aswi (at t00%) af ine properry rw wtui, the aeducson is mirned (msy nw exceed sia3,1 so) S
F. ❑Appfirant is Uie surviving spouse ot an'vWividual who would have quaGfied (or Hie deduGion under tha section whai he w she vras alive.
(Age Ntleceased veteran on tlate ddeefli )
A. Q Applicant was a member ot the U.S. Artned Forces during any of its wars.
B. � Applicant was honwably discharged.
C. Q Applinnt has a service connected disability of at least 10%
D. ❑ ApptiranPs disabiliry is evitlenced by ❑ CertiFrcate of elgibiliry 6om ihe IiMiana Department of Veterans Aftairs;
❑ Pension certificate;
❑ Awartl of compensatlon from Veterans Administra6on a DeDartrnent of Defense; w
- ❑ Veterans Administration Form 20-5455 "Tax Abatement Certi�cate
E. Q Applicant is [he surirving spouse ot an individual who v.ould have qualified for the deduction under this sectan when he w she was alive.
(Age o/ deceazed veferan on date o/ deafh )
A❑!Wp&ant a a veteran of World War I.
B. ❑App6canPs service is eviderced by ❑ Letter from Veterare Adm'viatration or Departrnenf � Defense; w
❑ Discnarge documents
❑ me asses�d �amanor� (a� �oo°,c,) of ine vroae�r tw wrurn a,a aed��am a da�red (may �or er�d szoa,sooi s—
.❑ The pmpuly is tha appGqnl's P�I resitlence. . �
E. ❑ The appficant o.metl the pmperiy (a wds buying if urder con6ac� for at least one year befora the date of ihis app5cation.