HomeMy WebLinkAboutVeterans_Olds"�rt�" � APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, �
i` -'°_ WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
•e��o, State Fortn 72662 (R8 / 4-04)
�.�.
Prescnbed by the Department of Local Govemment Finance �
INSTRUCTIONS: Please check appropriate box(es) pertaining to tax deduction. More than on ox �v
� er, a surviving
spouse who receives a deduction under Section IV may not receive a deduction under Section ll.)
G DATES: C p
REAL PROPERTY: DURING THE 12 MONTHS BEFORE MAY 11 OF THE YEAR THE DEDUCTION 13�0 APf�L�00%
MOBILE HOMES (6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO
OBTAIN THE DEDUCTION. �� ��
❑ I Totally disabled veteran (or veteran at leasf age 62 with at least f 0% disabilify) or su�Y�'§cS�P'�bu4��°�9�F�'Z'480
Complete seUions I, V and Vi. (IC 6-1.1-12-14)
❑ II Partially service-connected disabled veteran OR surviving spouse - Noi to exceed S24,960
Complete sections II, V and VI. (IC 6-1.1-12-13)
❑ III World War I Veteran - Not to exceed $78,720
Complete sectlons Iil, V and VI. (IC 6-7.1-72-77.4)
❑ IV Surviving spouse o( World War I Veteran - Not to exceed 578,720
Complete sections N, V, and VI. (IC 6-1.7-12-16)
Name of applicant (fi mi d last)
Address (stre t and nu e� ci y, stat I County
/d . �J� 0�2 il �7�(�
Applipnt ( does / oes not own property with another individual(s) be des spouse andlor another veteren.
This application is made for the purpose of obtaining S v`� "' D deduction from the assessed valuatlon of the following described taxable
property for the year 20�.
—�P" I
Taxing '"ct city, t , fownship) s the property in question: Parce� or Key number
eal Property ❑ Mobile Home (IC 6-1.1-7)
• . . � •• i'..
Appficant vras a member of the U.S. Armed Forces for at least 90 days (rwt necessanty dunng war time).
B. 0 Applicanl was hono2bty discharged.
C. � Applicant is: ❑ Totally disabled; or
❑ Ai least age 62 with at least 10% disability
D. ❑ Applipnfs disability is evidenced by. ❑ Certifinte of eGgibBity from the Indiana Departrnent of Veterans ARairs;
❑ Pension certifipte;
❑ Award of compensaUon (rom Veterans Administralion w Departrnent of Defense; or
❑ Veterens Administration Form 20.5455 "Tax Abatement Certificate'
E. � The assessed valuation (at 100%) of ihe property for which the deduction is daimed (may rrot exceed 5713,000) $
F. ❑ Applicant is ihe surviving spouse of an individual who would have qualified for the deduction under tttis section when he or she was alive.
(Age oldeceased veteran on date ol death )
• � . .
A. ApDJicant was a member of tha U.S. Armed Forces during any of its wars. � �
8. i%�'A Icant was honorably discharged.
C. Applic as a service<onnected disabiliry of at least 10%
D. licant's disability is evidenced by: ❑ Certificate of eligibility from ihe Indiana DepaNnent of Veterans Aftairs;
❑ Pension certi(wte;
❑ Award of compensatlon from Veterans AdminisVation or Department o( Defense; or
❑ Veterens Administration Form 20-5455'Tax Abatement CertiLcate'
E. ❑ Applicant is lhe surviving spouse of an individual who would have qualified for the deduction under this section when he or she was alive.
(Age o/deceased veteran on date oldeafh )
• . .
A � Applicant is a veteren of World War I.
� Applipnfs disabiGry is evidenced by: ❑ Letter from Veterans Administra6on or Departrnent o( Defense: or �
❑ Discharge documents
C. � The assessed valuation (at 100%,) of the property for which the deduc6on is daimed (maynot exceed 3163,000) $ �
D. ❑ The property is the applicant's prindpal residence. �
E. � The appliqnt wmed the pmperty (or wds buying d u�er canhad) for at least one year before the date of tfds appGption.
• � � �