HomeMy WebLinkAboutVeterans_English et'--•• APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
! WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
Stab Form 12652(R13 1 8-13)
u.. Praaa,bed by the Department of Local Gomm:rent Finance �'�4
INSTRUCTIONS: Ptease check appropriate box(es)pertaining to tax deduction.(More than one Max may � .'�"rig spouse who
receives a deduction under Section IV may not receive a deduction under S
FILING DATES:
REAL PROPERTY: DURING THE YEAR FOR WyIICH THE DEDUCTION IS SOUGHT.
MOBILE HOMES(IC 6-1.1-7)OR MANUFACTURED HOMES NOT ASSESSED AS REAL PROPERTY. RI G THE TWELVE(4�tik)NTHS BEFORE
MARCH 31 OF EACH YEAR FOR WHICH THE INDMDUAL WISHES TO OBTAIN THE DEDUCTION. 1♦ ((-UU 49
❑I Totally disabled veteran(or veteran at least age 62 with at least 10%disability)or surviving klig-Nat to exceed 51748'
Complete sections I,V and'A. (IC 5-1.1-12-14)
❑II Partially service-connected disabled veteran or surviving spouse-Not to exceed 324,960 s�
Complete sections II,V and VI. (IC 6-1.1-12-13) ' G013/41.1 VO\TOR
❑III World War I Veteran-Not to exceed 518,720
Complete sections III,V and VI. (IC 6-1.1.12-17.4) GOSON
❑IV Surviving spouse of World Wart Veteran-Not to exceed 518,720
Complete sections IV,V,and VI. (IC 6-1.1-12-16)
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Name of applicant(feat,middle,le Date of bhtt(marxh,day. ad
X/eniph £' n9 /�s a- y -y
Mess.
(number and street ay dale.end ZIP y
)I o5 N s (' /0 5 ale/ 4 Gv 1766 4- C`pn
Applicant (0 does ❑does not) own property with another Individual spouse Individuals)besides spse and/or another veteran.
This application is made for the purpose of obtaining I
ang$3 r0 deduction from the assessed valuation of the fonowtrq described taxable
properly for the year 20_ (If applicant desires that deduction be split among additional properties.fist those properties on additional sheet and attach
it to this application.)
g/p�s/t tt(5y. -xrt townztip) Is the property n question: Parcel or Key number
ass-'s� : P ./. .// di/ ❑Real Property ❑Mtile Home(IC 6-1.1-7) I . ( _o _ 5 Q/ 7
SECTIONI,-:Total DIsabillty,OR at least age 62 with at east 10%disability -,,,;,.. , ,_ • • ,
A It Apyikant was a member of the U.S.Armed Fares for at least 90 days(not necessa+aydump war lime).
B. t was hcnaby 6sCt .
C.❑Applicant is: ,�,�disabled:or
LXAt least age 62 vwth at least 10%dsarly
D.❑Applicant's&wt#ity is evidenced by ❑Certteate of eligibility from the Indiana Department of Veterans A'ays;
❑Pension certificate;
❑Award of compensation from Veterans Aaninistzion or Department of Defense;or
❑Veterans Administration Form 20-54551'ax Abatement Certificate
E.❑The assessed value of a5 of the tangible property t e applicant owns does not exceed 5143,160. Deductions claimed 5
F.❑App&ast is the stashing spouse of an individual who would have quashed for the deduction under this section when he or she was alive.
(Ape of deceased veteran on date of death
- • SECTION II -Partial Diaabiiry
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 to the deduction under this section when he or she was alive.
(Age of deceased veteran on date of death
SECTION III -World War I Veteran • . ..
A❑Applicant is a veteran of World War I.
B.❑Applicant's service is evidenced by. ❑Leta from Veterans Mncastatm or Depaarwnt of Defense;or
❑Discharge doam>enta
C.❑The assessed valuation of the property for which the deduction is dained(may not exceed 5206,S0tl) $
D.❑The properly is the applicant's principal residence.
E.❑The applicant owned the properly for was drying it under contract)for at least one year before the date of this application.
SECTIONS IV,V,AND V1 ARE ON REVERSE SIDE - j
SECTION IV - Surviving Spouse of a Wodd War I Veteran
A❑ 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 drying 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
6.❑ 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$
County Taxing Curie
Second county Taxing distinct
• - SECTION VI - Application Verification 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 tied(mart,day year
correct The intentional inclusion of false information on this form is
a criminal violation under IC 6-1.1-37-3 or 4.
[1�V sig`ror (c %
sra�efulig�I r as4 IName or ownnn:,aua:ar(typed«wren)
VETERAN DEDUCTION WORKSHEET
20 20 20
1. Total Disability($14480)
2. Partial disability(524960)
3. VA11 Veteran(518,720)
4. YAM surviving spouse(518.720)
5. Total deduction available(add lines I,2,3 and 4)
6. Amount 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 line 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.