HomeMy WebLinkAboutVeterans_Matthews "a APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
:4_,..lwe WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
• State Fenn 12562(R13 I 8-13)
Pnacntad by tie Deca:anent 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 IL)
FILING DATES:
REAL PROPERTY: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT. y 1
MOBILE HOMES(IC DURING THE
OR MANUFACTURED HOMES NOT ASSESSED AS REAL PROPERTY:DURING THE T4VEL 2)1' N S BEF
MARCH 31 OF EACH YEAR FOR WHICH THE INDMDUAL WISHES TO OBTAIN THE DEDUCTION.
❑I Toney disabled veteran(or veteran at least age 62 man at/east 10%disability)or surviving spouse-Not to exceed 512,480
Complete sections I.V and'A, (IC 6-1,1-12-14)
❑II Partially service-connected disabled veteran or surviving spouse-Not to exceed 524,960 APR 2 8 2014
Complete sections If V and VI. (IC 6-1.1.12-13)
❑III Wald War I Veteran-Not to exceed 51 5720 ,a
Complete sections 111,V and VI. (IC 6-1.1-12-17.4)
❑IV Surviving spouse of Wald War I Veteran-Not to exceed 518,720 A ryl COUNTY AUDITOR
Complete sections IV,V,and VI. (1C 6-1.1-12-16)
. _ _. _. APPLICANT-- ....:
Address(number and Wet pay,sbree,end ZIP code) County
Apperant (❑does ❑does not) own property°with another individual(s)besides spouse and/or another veteran.
This application is made for the purpose of obtaining$cr % ' deduction from the assessed valuation of the following descibed taxable
property for the year 20_ (If applicant desires that deduction be split among additional properties,Gs those properties on additional sheet and attach
it to this application.)
Taxing District(city,town,township) I Is the proper in question: Parcel or Hey number
/te>a,.i_fi Iy_ I❑Real Property ❑Mobile Home(IC 6-1.1-7) o o - oo .335,-o W 'L
. b.SECTIONI • Total ratability OR at least age 62 with at least l0%disability - ,._,•„_ :
A❑Appkani was an -roftheU.S.Armed Forces for at least 90 days(not rreressanydunng wartime). .a ,_/•� -A / rioo -co$t.6 a 2
❑Appkant was honorably discharged.
C.❑Applicent u: ❑Totally disabled;or
❑At least age 62 with at least 10%disabaty
D.❑Appicant's disabity is evidenced by ❑Caracole of eligitety from the Indiana Department of Veterans A°aus;
❑Pension certcate;
❑Award of compensation from Veterans Adnen isbavaf of Depaatners of Defense;or
❑Veterans Adninababon Form 20-5455-Tax Abatement Ceraicate•
E.❑The assessed value of al of the tangible property the appicant owns does It exceed 5143,160. Deductions damned$
F.❑Applicant a the surviving spouse of an'vdiridual wtm would have quaLSed for the deduction under this serson when he or she was give.
(Age of deceased veteran on date of death
.. . T SECTION 11 •PW Dlsabuiry • r". .a.'.v . _c.b , . .
A❑Applicant was a member of the U.S.Armed Forces during any of its wars.
B.❑Applicant was honorably discharged.
C.❑Appecant has a seMce 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 quatthed for the deduction under this section when he or she was alive.
(Age of deceased veteran on date of death )
. - SECTION el -Worth War I Veteran. . _ . , - - .
A❑Applicant Is a veteran of Vbnd War I.
B.❑Appicanl's service is evidenced by ❑Leber from Veterans Admimation or Department of Defense;or
❑Discharge documents
C.❑The assessed valet.=of the property for which the deduction is eabned(may not exceed 5206,507) $
D.❑The property is the applicants principal residence.
E.❑The appicant owned the property(or was buying it under contract)for at least one year before the date of this approatbn.
SECTIONS IV,V.AND VI ARE ON REVERSE SIDE t .-
RECEIPT FOR APPLICATION FOR TAX DEDUCTION
FOR DISABLED VETERAN,VJLM VETERAN OR SURVIVING SPOUSE OF CERTAIN VETERANS
I certify that the applicant filed on this date an application for the following deductions described on State Form 12662:
❑SECTION I ❑SECTION II ❑SECTION III ❑SECTION IV
Name of aeeacant(fit.middb,bN) Name pf eudler e
Parcel or Key trotter Date( lth. y_v yeaaa
02 n -A9- /00 - Coy. 334'-o A / yip/ y
a&-/ 7 - d ' , too - coy. G y, l -o a /
SECTION IV- Surviving Spouse of a World War I Veteran
FL❑ Applicant is the surviving spouse of an individual who served in the U.S.Armed Forces before November 12.1918.
B.❑ The service of the deceased spouse is evidenced by ❑ Letter from the Veterans Administration or the Department of Defense;or
❑ Honorable discharge documents
C.❑ The deceased spouse received an honorable discharge.
SECTION V -Additional Information
A.❑ Applicant owns the property on which the deduction 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 Recorders office.
Record number page
B.❑ Applicant has applied or intends to apply for one or more of these deductions on other property in this county or in another county.
❑Yes ❑No Amount S
camty Taxing district
Secona county Taxing dmna
• SECTION VI - Application Vaditadon and Auditor Signature
• - I certify that this application was filed in my office.
I certify that the information provided in this application is true and Date nee(month,day ne
correct.The intentional inclusion of false information on this form is c{`,g/z T u
a criminal violation under IC 6-1.1-37-3 or 4. sign urn of county aupaor
Sige" - • a•• .nto e9al rep tai, Name of county auditor Or
VETERAN DEDUCTION WORKSHEET •
20 20 I 20
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1. Total Disability($12,480)
2. Partial disability(524.960)
3. NAM Veteran(518.720)
a. NNd surviving spouse(518,720)
5. Total deduction available(add tines 1,2,3 and 4)
6. Mount applied to real estate key number
7. Amount applied to personal property duplicate number
8. Amount applied to mobile home duplicate number
9. Total deduction applied to taxable property(add lines 6,7 and 8)
10. Deduction available for excise'(subtract line 9 from an 5)
11. Excise Credit
May be used as an excise tax credit on either the Motor Vehicle Tax(IC 6-6-5-5)or Aircraft License Excise Tax(IC 6-6-6.5-13).
For motor vehicles,the unused portion of the veteran deduction reduces the annual excise tax in the amount of two dollars
(52.00)on each one hundred dollars(5100.00)of taxable value or major portion thereof.
For aircraft,the credit equals the amount of the unused portion of the veteran deduction multiplied by 0.07.
For more information,see IC 6-6-5-5 and IC 6-6-6.5-13.
The information contained on this form is CONFIDENTIAL according to IC 6-1.1-35-9.
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