Veterans_Thompson"" � APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERAN�� ���
•' . WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETE
�, Scate Form 72662 (R9 f 5-OB)
�� Presaibed by Ihe Deparhnen� o( Local Govemment Flnance D E C 2 8 (��q
�TRUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one 6ox may be checked2ifdWever, a surviving
spouse who receives a deduction under Section IV may not receive a deduction undeLSection 1�
FILING DATES: �j(a,�,
REAL PROPERTY: DURING THE 12 MONTHS BEFORE JUNE11 OF THE YEAR THE DEDUCTION IS TO APACY. �
MOBILE HOMES (6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR P/RR�PN7G.{8UN0WIqJ71�(�jISHES TO
OBTAIN THE DEDUCTION.
❑ I Totally disabled veteran (or veteren a( least age 62 with at least 10% disabilityJ or surviving spouse - No[ to exceed 572,480
Complete sections I, V and VI. pC 6-7.7-12-14)
� II Partially service-connected disabled veteran OR surviving spouse - Not to ezceed 524,960 � n ',,
Complete seUions II, V and VI. (IC 6-1.1-12-13) � C�-�`'`�'
❑ III World War I Veteran - Not to exceed 518.720 �)
Complete sections III, V and VI. (IC 61.1-12-77.4) ��
❑ IV Surviving spouse ot Wor1d War I Veteran - Not to exceed 518.720
seclions IV, V, and VI. (IC 6-1.1-7
Name of appliwnt (first, middle, las!)
Address (st2ef a�W number, rily,
�9i s f s r
ZIP code)
( dces I dces not ) own property vri�h another individual(s) besides
�LN, �`76 70
and/or anoMer veteran.
U
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applicaGon is made for Ihe purpose of obiaining 5 0[ `f � o• deduction 6om the assessed valua6on of ihe follovAng described taxable
erty tor the year 2Q . '
town,
Is the property in question: Parcel or
❑ Real Property ❑ Mobile Home (IC G7.1-7)
Appficant vras a rtrember of tlie U.S. Artned Forces fn at leasi 90 days (nW necessarily dunng war tvne�
B. O Appfinm vas lanorady disdiarged.
C. � Appfinrrt is: ❑ TotaAy disaded; w
❑ At least age 62 wdh at least 10% disabdiry
D. � AppGnn['s disabiNy is evidenced by ❑ Certifrate ot e5gibdil � j�
❑ Pentim certificate; fl 1 Y�A � n �_
� VdAJr
7n �
Av.ard of c«npe��
❑ Veterans Admw ��
E. ❑� The assessed valuaUon (at 700%) of Ne property.for which the ded �' \ \�. �— -
l9 v/"��v��
F. O APW�rcan� is tt�e surrivmg sPW� of an ind�ividual vAw would have q� � J(aJV ie.
(Age of deoeased �eteran on date adeatl� )�— --
A�� Applirant was a member of the U.S. Armed Fwces during any of i �
B.� Appli�ant vras horrorabty discharged. —
C.� Applipnt has a service-connected disability o( at least 10%
D. ,� AppliqnYs disabiGty is evidenced by. � Certificate of eligit —
� Pension certificatc_
� ❑ Award of wmpen:
❑ Veterans Adminis—
E. ❑ Applicant is ihe surviving spouse ot an indivirli�al whn wrn�lA havP qw
(Age oI deceased veteian on date o!
ApplKant is a veteran oT World War I.
Appl'�rt's disab2iry is evidenced by: ❑ Leiter fran Veterans AdministraGOn or Departmerrt W Defense; or
❑ Distharge documenis
C- 0 The assessed valua6on (at 100°.6) W t�e poperty fa vRuUi the deduction is daimed (may rrot exceed %763.000) S_
D. � The property is ihe appiicarrt's prindpal residence.
E. � The appficant owned ihe properry (a was buy'ug if urMer cmtraG) fw at least me year before Me date oi this applicaUm.
ir
s alive.