HomeMy WebLinkAboutVeterans_WildtAPPLICATION FOR PROPERTY TAX BENEFITS FOR DISABLED VETERANS
Q. .
AND SURVIVING SPOUSES OF CERTAIN VETERANS
ter' State Form 12662 (R20 / 6-26)
Prescribed by the Department of Local Government Finance
Instructions: Please check appropriate box(es) pertaining to the applicable tax deduction or credit. More than one (1) box may be checked; however, an
individual who claims a deduction under Section I may not claim a credit under Section 11 or Section III or a deduction under Section V for that
same assessment date. (IC 6-1.1-12-14(d); lC 6-1.1-12-14.5(d))
Filing Date: This form must be completed, signed, and filed by January 15 of the calendar year in which the property taxes are first due and payable.
File with the county auditor of the county where the property is located.
❑ I Totally Disabled Veteran or Surviving Spouse —Deduction of 100% of the assessed value of principal place of residence
Complete Sections 1, Vl, and Vll. (lC 6-1.1-12-14)
IiJ II Veteran with Service -Connected Disability or Surviving Spouse — Credit not to exceed $350
Complete Sections I/, VI, and Vll. (IC 6-1.1-51.3-6)
Lta III Veteran at least Age 62 with at least 10% Disability or Surviving Spouse — Credit not to exceed $250
Complete Sections lll, Vl, and VII. (IC 6-1.1-51.3-5)
❑ IV Surviving Spouse of World War I Veteran — Deduction not to exceed $18,720
Complete Sections IV, VI, and Vll. (IC 6-1.1-12-16)
❑ V Deduction for Homestead Donated to Veteran
Complete Sections V, VI, and VII. (IC 64.1-12-14.5)
•-
Name of Applicant (first, middle, last)
•
Date of Birth (month, day, year)
Telephone Number
Wildt, Michael R
Address
3 -1 7-11JI
f!�•) �ST � �
(number and street, city, state, and ZIP code)
County
Email Address
2928 W 50 S Princeton, IN 47670
Gibson
Applicant (❑ does ❑ does not) own property with another individual(s) besides spouse and/or another veteran.
This application is made for the purpose of obtaining $ deduction from the assessed valuation of the following described taxable
property and/or $ credit against local property taxes imposed on the following described taxable property for the year 20
(If applicant desires that a credit be split among additional list those
properties, properties on additional sheet and attach it to this application.
The deductions under Section I and Section V may only apply to the applicant's homestead property.)
_11axing District (city, town, townships) Is the property in question: Parcel or Key Number
atoka Township ® Real Property ❑ Mobile Home (IC 6-1.1-7) 26-11-15-100-003.751-027
• • . • . . •
A. ❑ Applicant served in the military or naval forces of the United States for at least ninety (90) days (not necessarily during war time).
B. ❑Applicant was honorably discharged.
C. ❑ Applicant has a total disability.
D. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility (Section VIII) from the Indiana Department of Veterans Affairs ("IDVA") after IDVA
has determined that the individual's disability qualifies the individual to receive a deduction under IC 6-
1.1-12-14;
❑ Pension certificate from the U.S. Department of Veterans Affairs; or
❑ Award of compensation from U.S. Department of Veterans Affairs
E. ❑ Applicant has resided in Indiana for at least one (1) year before the assessment date for which this deduction is claimed.
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 and the applicant
has not subsequently remarried.
G. ❑ Applicant uses the property on which the deduction is claimed as the applicant's homestead (principal place of residence).
A veteran who claims this deduction for an assessment date may not also claim the Homestead Donated to Veteran Deduction under IC 6-1.1-12-
14.5 or receive a local loro= tax credit under IC 6-1.1-51.3 for that same assessment date.
• • • • • r •- •- • ib
A. ❑ Applicant served in the military or naval forces of the United States during any of its wars.
B. ❑ Applicant was honorably discharged.
C. ❑ Applicant has a service -connected disability of at least 10% or more.
D. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility (Section VIII) from the Indiana Department of Veterans Affairs ("IDVA") after IDVA
has determined that the individual's disability qualifies the individual to receive a credit under IC 6-1.1-
51.3-6;
❑ Pension certificate from the U.S. Department of Veterans Affairs; or
❑ Award of compensation or disability compensation check from U.S. Department of Veterans Affairs
❑ Applicant is the surviving spouse of an individual who would have qualified for the credit under this section when he or she was alive.
Page 1 of 2A
A. ❑ Applicant served in the military or naval forces of the United States for at least ninety (90) days (not necessarily during war time).
B. ❑ Applicant was honorably discharged.
C. ❑ Applicant is at least age 62 with at least 10% disability.
0. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility (Section Vill) from the Indiana Department of Veterans Affairs ("IDVA") after IDVA
has determined that the individual's disability qualifies the individual to receive a deduction under IC 6-
1.1-12-14;
❑ Pension certificate from the U.S. Department of Veterans Affairs; or
❑ Award of compensation from U.S. Department of Veterans Affairs
E. ❑ Applicant is the surviving spouse of an individual who: (1) would have qualified for the credit under this section when he or she was alive; or (2) was killed
in action, died while serving on active duty, or died while performing inactive duty training. (Age of deceased veteran on date of death 1
A. ❑ Applicant is the surviving spouse of an individual who served in the military or naval forces of the United States before November 12, 1918.
B. ❑ The service of the deceased spouse is evidence by: ❑ Letter from the U.S. Department of Veterans Affairs; or
❑ Honorable discharge documents
C. ❑ The deceased spouse received an honorable discharge.
A. ❑ Applicant served in the military or naval forces of the United States for at least ninety (90) days.
B. ❑ Applicant was honorably discharged.
C. ❑ Applicant has a disability of at least 50%.
D. ❑ Applicant's disability is evidenced by: ❑ Pension certificate or an award of compensation issued by the U.S. Department of Veterans Affairs; or
❑ A certificate of eligibility (Section Vill) issued to the individual by the Indiana Department of Veterans'
Affairs ("IDVA") after IDVA has determined that the individual's disability qualifies the individual to
receive a deduction under IC 6-1.1-12-14.5
E. ❑ Applicant's homestead was conveyed without charge to the applicant who is the owner of the homestead by an organization that is exempt from
income taxation under the federal Internal Revenue Code.
The amount of the deduction is determined as follows:
1. If the applicant is totally disabled, the deduction is equal to 100% of the assessed value of the homestead.
2. If the applicant has a disability of at least 90% but is not totally disabled, the deduction is equal to 90% of the assessed value of the homestead.
3. If the applicant has a disability of at least 80% but less than 90%, the deduction is equal to 80% of the assessed value of the homestead.
4. If the applicant has a disability of at least 70% but less than 80%, the deduction is equal to 70% of the assessed value of the homestead.
5. If the applicant has a disability of at least 60% but less than 70%, the deduction is equal to 60% of the assessed value of the homestead.
6. If the applicant has a disability of at least 50% but less than 60%, the deduction is equal to 50% of the assessed value of the homestead.
veteran who claims this deduction for an assessment date may not also claim the Totally Disabled Veteran Deduction under IC 6-1.1-12-14 for
.nat same assessment date. Moreover, an unused portion of this deduction may NOT be applied to excise taxes.
A. ❑ Applicant owns the property on which the deduction or credit is claimed or is buying it under contract that provides that the applicant is to pay the
property taxes, which contract, or a memorandum of the contract, is recorded in the County Recorder's office.
Record Number
(Note that a person applying for a deduction under Section V must own the property.)
❑ Applicant has applied or intends to apply for one or more of these credits on other property in this county or in another county.
❑ Yes ❑ No Amount $
County
Second County
Page
I certify that the information provided in this application is true and
correct. The intentional inclusion of false information on this form is a
criminal violation under IC 6-1.1-37-3 or -4
Signature of
Veteran's Military Service
1. More than ninety (90) days
of service (check one) I VA disability
—i Wartime service ❑ Peacetime service
Accredited IDVA staff unty Veteran
Taxing District
Taxing District
I certify that this application was filed in my office
Date Filed (month, day, year)
Signature of County Auditor
a.
Name of County Auditor (typed or written)
Michael A Watkins
Veteran's character of discharge
O'Honorable or Under Honorable Conditions
ing
1 -1
Officer signature
rv� C-)
Page 2 of 2
Veteran's date of birth (month, day, year)
3 1 ?-1`��
Date (month, day, year)
M APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
' t State Form 12662(R11/10-06)
'''— ' Prescribed by the Department of Local Government Finance
INSTRUCTIONS: 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 under Section II.)
FILING DATES:
REAL PROPERTY: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT.
MOBILE HOMES(IC 6-1.1-7)OR MANUFACTURED HOMES NOT ASSESSED AS REAL PS�PMq l I •U- il, ELVE(12)MONTHS
BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIIE b h,UCTI y •.
® I Totally disabled veteran(or veteran at least age 62 with at least 10%disability) su ° .spouse-Not to exceed 512.480•
��N,q Complete sections I.V and VI. (IC 6-1.1-12-14) G 6 2014
Y" II Partially service-connected disabled veteran OR surviving spouse-Not to exceed S24ry 4 v
Complete sections Il.V and VI. (IC 6-1.1-12-13)
0 III World War I Veteran-Not to exceed 518,720
Complete sections III,V and VI. (IC 6-1.1-12-17.4)
❑IV Surviving spouse of World War I Veteran-Not to exceed 518.720 GIBBON COUNTY AUDITOR
Complete sections IV,V.and VI. (IC 6-1.1-12-16)
1-4._`? I- =yi p I c: .: ._:.. ,ice APPLICANT" -€; - _:F :€, rw .. ti..rAi".
N me of plicant rst,m' e,IIQ I
Address(street and number,city,stand ZIP code) County
Applicant [)does aoes not ) own property with another individual(s)besides spouse and/or another veteran.
This application is made for the purpose of obtaining S L�(O"1 6 deduction from the assessed valuation of the following described taxable
property for the year 20 .
Taxing District(city,town,township) I e property in question: I Parcel or Key number
I 01 Real Property ❑ Mobile Home(IC 6-1.1-7) a4,/ /6/06 co 3 7_5/ °a7
,`2-c aL ;y,:- "/A`A` SECTION I.p talDisatiiiit OR at leista•e 62 with at least 10%disabili 723, 461;rte..... :?'1 r
A Applcant was a member of the U.S.Armed Forces for at least 90 days(not necessady during war time).
B. Applicant was honorably discharged.
C.❑Applicant 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 compensation from Veterans Administration or Department of Defense;or
❑Veterans Administration Form 20-5455 Tax Abatement Certificate'
E.❑The assessed valuation(at 100%)of the properly for which the deduction is claimed(may not exceed$143,160) S
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 deceased veteran on date of death )
;.rrrrrrdddddd,,,, ...:. `,'.: . -za w :s-..,.: n.. : ,'. f".t'=SECTION II`- Partial'Disabilit -';. -x ,r s1".. /;:.t3 .vcr- ` ,y1
A. Applicant was a member of the U.S.Armed Forces during any of Its wars.
B. Applicant was honorably discharged.
C. Applicant has a service connected disability of at least 10%
D.❑Applicant's disability is evidenced by: ❑Certificate of eligibility from the Indiana Department of Veterans Affairs;
❑Pension certificate;
❑Award of compensation from Veterans Administration or Department of Defense;or
❑Veterans Administration Form 20-5455'Tax Abatement Certificate'
E. ❑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 deceased veteran on date of death )
r' - `-'mac r,..,,c,h * Tic.. '.:.''>..- g SECTION ED:-.World'Wat - r : ^C- -- ate:; „a .'.$3:'xrs,P� dix4 ti:-t?.d'
A. ❑Applicant is a veteran of World War I.
B. ❑Applicant's service is evidenced by: ❑Letter from Veterans Administration or Department of Defense;or
❑Discharge documents
C.❑The assessed valuation(at 100%)of the property for which the deduction is claimed(may not exceed S206,500) S
D.❑The property is the applicant's principal residence.
E.❑The applicant owned the property(or was buying it under contract)for at least one year before the date of this application.
y. ,.vc ,-' tea`." `frt ; SECTIONS Ca V,AND VI ARE ON REVERSE c=? F ,. ',,ryy:a' .,. -- ..1 ;1r'V - #;