Veterans_Retana�" APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
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WWI VETERANS AND SURVMNG SPOUSES OF CERTAIN VETE � ia�
♦, �' State Fortn 72662 (fi9 / S-06) i g
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,.� Prescribed by the Departmen� ot local Govemment Finance "
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! UCTIONS: Please check appropriate box(es) pertaining to tax dedua?on. (More than one box m�A �c1�e e(x}�}vever, a surviving
" spouse who receives a deduction under Section t`!.may not receive a deduction under Sect�on�l.�
FILING DATES:
REAL PROPERTY: DURING THE 12 MONTHS BEFORE JUNE11 OF THE YEAR THE DEDUCTION IS'�O'fjP��LY3�
MOBILE HOMES (6-1.1-7): DURING THE 12 MONTF�S8EE�@E� CH YEAR FOR WHICH THF,%INDIV AL WISHES TO
OBTAIN THE DEDUCTION. I ���� GIBSON COUNTY AUDITOR
Name of
❑ I Totally disabled veteran (or ve(e.
Complete sections I, V and VI.
❑ II Partially service-connected disal
Complete sec:ions II, V and VI.
❑ III World War I Veteran - Not to ezc
Complete sections III, V and VI.
n IV Surviving spouse of World War I
sections IV, V, and VI.
last)
Address (street arM �umber, city; state,
APP�iwnt 1 does / does not ) wm ProPer�' with
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�Z31.�-� 1 �
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or surviving spouse - Not to exceed 572.480
524.960
individual(s) besides spouse and/or another vete2n.
This application is made for the purpose of obtaining S<�L deduction from the assessed vatualion of the following described taxaWe
y for the year 20_
District (dty, fown, township) Is the property in question:
, ��m „� C , ( .. �Real Property ❑ Mobile Home (IC 61.7-7)
ATl AppGcant was a member of ihe U.S. Fvmed Forces fa at least 90 days (nW necessarily during war time}
B. ❑ AppGnnt was Iwnaably disdiarged.
C. ❑ Ap�cant is: � Totally disaded; or
❑ Al least age 62 wi�h at leasl 70%disability
D. ❑ ApplicanYs disabi(Ay is evidmced by ❑ Certifuale of e6yibAity from tl�e Indiana Departrnent of Veterans Affavs;
❑ Pensim certi(xate:
� Award of cwnpensation 6om Veterar�s Adm"viistra�on or Departrnent of Deferue: a
❑ Ve[erara Administra0on Form 245455 Tau Abatemerrt Cerlifinte'
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E. ❑- The assessed valuation (at 100%10( the property for which Ne deduction is daimed (may rrot exceed 5713,000) S
F. � App6cant is ttre surrivug spouse of an irdividual who would have Qualified fa ihe deducUOn under tltis section when he or she was alive.
(Age o7deceased �ete2n on date W dea8r )
A❑ Applicant was a member of the U.S. Artned Faces during any of its wars.
B. � Applicant was horrorably discharged.
C. ❑ Applipnt has a service-conneded disability of at least 10%
D. 0 ApplicanPs disabiGry is evidenced by ❑ Certificate of eligibiliry from the Indiana Departrnent of Veterans Aftairs;
❑ Pension certificate; �
❑ A rd of compensation from Veterans Administration or Deparfi�ent of De(ense; or
Veterans AdminisValion Fartn 20-5455'Tax Aba[ement Certfirate'
E. � Applipnt is Ne surviving spouse of an indivirf��al whn wrntl�i haw qualified for the deduction u�er this section when he a she was alive. �
(Age of deceased veteran on date o! dealh )
Appfiqnt is a veteran af World War I.
Applipnt's d�sabSty is evidenced by: � Letter from Veterans Administration a DeparVrw.nt of Defense; a
❑ D'SCf�arge doaimenis
C. ❑ The assessed valualion (at 100°b) d ihe property fa whidi the deducuon is daimed (may nW exceed $163,000) 5_
D., ❑ The pmpe�ry is the applinM's printipai residence.
E. �,The applimrrt owned the properry (or wds buying i( w�der cartrac!) fw at least one year befwe the date of this app6catim.