Veterans_Richardson�
APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS
WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
State Form 12662 (R4/t-00)
Prescribed by the State Board of Taz Commissioners
S: 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 receive a deduction u�n�d-e-r� S ll.)
THIS APPLICATION MUST BE FILED DURING THE 12 MONTHS BEFORE MAY 11 OF THE Y�T�E EDUQaTTON� APPLY.
❑ I Totally disabled veteran (or vete�an at least age 62 wifh a! least 70% disabilityJ or survrvmg spouse - Not�to exceed 52.000
Complete sections I, V and VI. (IC 6-1.1-12-14) � pN p 2 Z001
O II Partially service-connecied disabled veteran OF surviving spouse - Not to exceed 54,000
Complete sections II, V and VL QC 6-1.1-12-13)
O III worid War I Veteran - Noi to exceed 53,000
Complete sections III, V and VI. (IC 6-1.7-12-1Z4) GIBSON COUNTY AUDITOR
O IV Surviving spouse of Wodd War I Veteran - Not to exceed 53,000
Complete sections IV, V and VI. QC 6-1.7-12-76)
Name of applicant
Applicant ( does / ces not own property vnth another individual(s) besides spouse and/or another veteran.
This application is made for the purpose of obiaining S_ ��0 deduction from the assessed valuation of the tollovring descnbed
ta�cable property tor the year 20�
or
A. ❑ Applicant was a member of the U.S. Armed Forces for at least 90 days (not necessanly during war timeJ.
B. � Applicant was honorably discharged.
C. ❑ Applicant is
D. �pplicant's disability is evidenced by:
❑ Totally disabled: or
G At least age 62 with at least 70% disability
❑ Certifira+= ^' -"" �� a Indiana Departmeni of Veterans AHairs;
Tax Abatemeni Certificate'
under this seciion when he or she was alive
❑ Letter from Veterans Adminisiration or Department of Detense; or
❑ Discharge documents
C. ❑ The assessed valuation of Ihe property tor which the deduction is claimed (may nof exceed 526,000) S
D. ❑ The pwperry is the applicanPs principal residence.
E. O The applicant owned the property (or was buying it unde� contractJ for at least one year before the date of this application.
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