HomeMy WebLinkAboutVeterans_DavisAPPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERA� T�ED
�'- Stale Form 12662 (R11 ! 10-08) 1 1
�s Prescribed by the Department of Lopl Govemment Finance
INSTRt1CTlONS: Please check appropriate box(es) pertaining to tax deducdon. (More than one box ma��hQc{e�}�wever, a surviving
spouse who receives a deduction under Section lV may not receive a deduction under Section ll.)
FILING DATES:
REAL PROPERTY: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT.
MOBILE HOMES (IC 6-1.1-7) OR MANUFACTURED HOMES NOTASSESSEDAS REAL PROP LVE (12) MONTHS
BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN TH . NTY AUDITOR
� I Totally disabled veteran (or veteren at least age 62 with at least 10'/ disabitity) or surviving spouse - Not to exceed
Complete sections I, V and VI. (IC 6-1.1-12-14) �� //
� II Partially service-connected disabled veteran OR surviving spause - Not to exceed $24,96� ,a; i � r-(!`lC.k�
Compiete sections Ii, V and Vl. (IC 6-1.1-12-13) Y
❑ III World War I Veteran - Not to exceed $18,720 �
Complete sections III, V and VI. (IC 6-1.1-12-17.4)
❑ IV Surviving spouse of World War I Veteran - Not to exceed $18,720
Complete secdons IV, V, and VI. (IC 6-1.1-12-16)
Name of applicant (first, middle, last)
% R . �J S �
Address (street end number, city, state, and ZIP code) County
S' � S V �L '�'"flo65 � 8�O
Applicant Qdoes �dces not } own property with another individual(s) besides spouse and/or another veteran.
�y 04
This application is made for the purpose of obtaining $�/ ���. ~-' deduction from the assessed valuation of the following described tauable
property for the year 20
Taxing Oistrict (city, town, township) Is the property in question: Parcel or Key number
❑ Real Property ❑ Mobile Home (IC 6-1.1-7) _ —j — . � � � � � �
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A. � ApplicaM was a member af the U.S. Artned Forces for at ieast 90 days (rrot necessarily during war 6me).
B. Applicant was honorably discharged.
C. Applicarrt is: ❑ Totally disabled; or
� At least age 62 with at least 10% disability
D. � Applicant's disability is evidenced by: � Certificate of eligibility from the Indiana Department of Veterans Affairs;
Pension certificate;
❑ Award of compensatian from Veterans Administration or Department of Defense; or
❑ Veterans Administration Fortn 2Q5455 "Tax Abatement Certficate"
E. Q The assessed vdluation (at 100%) aF the property for which the deduciion is claimed (may not exceed $143, T 60) $
F. � Applicant is the surviving spouse of an individual who would have qualified for the deduction under this section when he or she was alive.
(Age of deaaased veteran on dafe of death )
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A. � Applicant was a member of the U.S. Artned Forces during any of its wars.
B. � Applicant was honorably discharged.
C. [� Applicant has a service connected disability of at least 10%
D. � ApplicanYs disability is evidenced by: � Certificate of eligibility from the Indiana Department of Veterans Affairs;
❑ Pension ce�tificate;
❑ Award of compensation from Veterans Administration or Department of Defense; or
❑ Veterans Administration Fonn 20-5455 "Tax Abatement Certificate"
E. � Applicant is the surviving spouse of an indlvidual who would have qualified for the deduction under this section when he or she was alive.
(Age of deceased veteran on date of death )
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A QApplicant is a veteran of World War 1.
B. QApplicanYs service is evidenced by: ❑ Letter irom Veterans Administration or Department of Defense; or
� Discharge documents
C. � The assessed valuation (at 100%) of the praperty Tor which the deduction is claimed (may rmt exceed $21J6,500) $
D. Q The property is the applicanYs principal iesidence.
E. Q The appliwnt o�nmed the property (or was buying it �der contrac� for at least one year beFore the date of this application.
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