HomeMy WebLinkAboutVeterans_Buchannan'•? —'`"' APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERAN ���
° WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETE N�
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�, State Fwm 12662 (R9 / SOB)
w PrestriDed by Ihe Departmenl of Local Govemment Finance J UL L+
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'�ZUCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More fhan one box may be checke .`ltbwever, a surviving
spouse who receives a deduction under Section IV may not receive a deduction under Section Il.)
FILING DATES: �I
REAL PROPERTY: DURING THE 12 MONTHS BEFORE JUNE11 OF THE YEAR THE DEDUCTI8� TO A�PLY� �
MOBILE HOMES (6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FORW�Rb1BNA701)(��LWISHES TO
OBTAIN THE DEDUCTION. �
❑ I Totally disabled veteran (or veteran at leas( age 62 vnfh at least 70% disabilityJ or surviving spouse - Not ro
Complete sections I, V and VI. QC 6-1.7-72-14) / �
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� I� Partially service-connected disabled veteran OR surviving spouse - Not to exceed 524,960
Complete sections II, V and VI. (IC 6-7.1-12-73)
❑ III Worid War 1 Veteran - Not to exceed 578.720
Complete sections Iil. V and VI. (IC 6-1.7-72-17.4)
❑ IV Surviving spouse of Worfd War I Veteran - Not to exceed 518,720
Complete seclions IV, V, and VI. (IC fr7.1-72-16)
Nama of applicant (first, middle, last)
Address (streef artd number, cAy, slate, ZIP code) n� County
f N, 5- sr /�',.�c� � o.v ZN, '�'�G 7 0�/
Appliwnt ( dces 1 dces not ) own property vrith another individual(s) besides spouse andlor another veteran.
This a ication is made for the u � `/ �
ppl p rpose of obtaining S ��% 910�. -' deduclion from the assessed valuaGon of ihe tdlowing described tax e
ProP�Y for ihe year 20_ �/ c..�/ �G �%%�/� / �
Taxing Distriq (dty, town, township) Is the property in question: Parcel or Key number
❑ Real Pmperly ❑ Mobile Home (IC Fr1.1-7) .
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0. r] Applicant was a member of ihe U.S. Nmed Forces fa at least 90 days (nW necessarify during war 6me�
B. (] MP6canl �ras hora2dy disd�arged.
C. � Appfipnt is: ❑ Totally dcaded; w ..
0 At least age 62 wilh at least 1096 disabiliry
D. [] A�Ii�anCs d�ad�tty is evidenced by n CeAificate W efigibdity Gom tlre Indena Departrnent d Veteians ARavs;
❑ Perrsim cetGfinie;
�: Avrard ot mmpensatim hom Veteraru Admmistration or Departrnent of Deferrse: or '
❑ Veterans Admirristralion Form 20.5455'fax Abatemerrt Certifitate'
E � The assessed valua6on (at 100°/ ) of ihe {xoperty for which the deduction is daimed (may rrot exceed 5773.000) S
F. ❑ Applicant is tlie wrviving spouse of an vdividual who wwld have qualfied (or the deduction under tlus secGOn when he or she vras alive.
(Age o/deceased veteran on dafe W deattr )
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A[]� Applinnt was a member of the U.S. Armed Forces during any of its wars. / J L /�6 �
B. �I Applicanl was honwably disc�harged. ��1/LL?L60�C �9'�%!�'�
C. � Applicant has a service-connected disabiiity of at least 70% �/rA�'y
D. � ApplinnYs disabiGty is evidenced by � Certifiwte of eligibiliry from the Indiana Departrnent of Ve[erans A(fairs:
❑ Pension certifiqfe;
❑ Award of compensation from Veterans Administrabon or Deparlment of Defense; or
❑ Veterans AdminisiraGon Fortn 20.5455'Tax Abatement Certificate'
E. ❑ Applicani is the surviving spouse of an indivirl�ial whn wrnilA havn qualified fw ihe deduction under Nis section when he or she was alive.
(Age oldeceased veteran on date of death 1
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�'1 Applipnt is a veteran M World War I.
� AppiipnCs disa6£rty is evkJer�ced by ❑ Letter fran Veterans Administrafion or Deparmient of Defense: or
❑ Disdiarge dowmenfs
c. O rne assessee raluaSOn (at t oo°�) a me poperry r« wreai me ded,cuon is davned (may not exceed 8763,000) 5
D. � The property is the appGtanYs prindpal resttlence.
E. � The ap{dkarrt ovmed the properiy (a was buying it under cmtract) fw al least one year before the date oi this applicalion.
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