HomeMy WebLinkAboutVeterans_Loveless aj:t--•,. APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
if" WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
` i State Fenn 12662(R1]I613)
\•a. PresWed by Ms Department of Local Government Finance
INSTRUCTIONS: Please check appropriate box(es)pertaining to tax deduction.(Mom than one box may be checked;however,a surviving spouse who
receives a deduction under Secton IV may not receive a deduction under Section It)
FILING DATES:
REAL PROPERTY: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT. ggg
MOBILE HOMES(IC 6-1.1-7)OR MANUFACTURED HOMES NOT ASSESSED AS REAL PROPERTY:DURING THE TWELVE(12 T B OR;
MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DEDUCTION. d■�M 2GYW0
❑I Total),disabled veteran(or veteran at least age 62 with at least 10%disability)or surviving spouse-Not to ex $1 •
Complete sections I,V and VI. (IC 6-1.1-12-14)
❑II Partially service-connected disabled veteran or surviving spouse-Not to exceed 524.960 JUN 1 7 9
Complete sections ll,V and V. (IC 6-1.1-12-13) 2014
❑Ili W 1d War I Veteran-Not to exceed 518,720
Complete sections III.V and VI. (IC 61.1-12-17.4)
limicoccar-
❑IV Surviving spouse of World War I Veteran-Not to exceed 518,720 •
Complete sections IV.V and VI. (IC 61.1-12-I6) GIBSONCOUNTYAUDITOR
Neme of epplmsnt(Fat middle.last) De•--•u...r_....e.....-.
T� Ier S Loveless 9 - 5 - $�
Address nombet and street cay.tare,and ZIP code)�2 Pr , 1 C�u.��ry
ID IOSeui� 'L.)RS{\tVtli I\ IMC¢VPp\ \ U LJtbbso4
Applicant 00 does ❑does not) own property with another individual(s)besides spouse and/or another veteran.
This application is made for the purpose of obtaining 5 deduction from the assessed valuation of the following described taxable
properly for the year 20_ (II applicant desires that deduction be split among additional properties.list those properties on additional sheet and attach
it to this application.)
Tas g Dbbict(arty,town,township) I Is the property in question: Parcel or Key number _
®Real Property ❑Motile Home(IC 6-1.1-7) I x(6_14-17-I li t -CYS I.. O a Oa Si
A❑Appicant was a member of the U.S.Armed Forces for at least 90 days(not necessaNydunrg war tme).
B.❑Appiont vas honorably discharged.
C.❑Appicenl u: ❑Totally disabled:or
❑At least age 62 with at least 10%disability
D.❑Applicant's disabduy is evidenced by ❑Certkate of eligibility from the Indiana Department of Veterans Affairs:
❑Pension cent/rate;
❑Award of compensation from Veterans Administration or Department of Defense;or
❑Veterans Adnvistmtion Rem 20-5455 Tax Abatement Certificate'
E.❑The assessed value of al of the tangible property the appiant owns does not exceed$143,160. Deducions darned S
F.❑Applicant Is the surviving spouse of an imdkidual who would have quabied for the deduction under tis secliorl when he or she was aloe.
(Age of deceased veteran on date of clean
SECTION 0 -Penal Disability •
A.2Appicant was a member of the U.S.Armed Forces during any of its wan.
B.grAppicant was honorably discharged.
C.Eklppicant 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:
r❑Pension certificate:
Lr Award of compensation from Veterans Adminisualon or Department of Defense;«
❑Veterans Administration Form 20-5455'The Abatement Certificate'
E.['Applicant is the surviving spouse of an individual who would have quashed for the deduction under this section when he or she was alive.
(Age of deceased veteran on date of death
SECTION III -Word War Veteran
A.❑App&an Is a veteran of Word Wirt.
B.❑Applicant's service is evidenced by. ❑Letter tan Veterans Mtn or Department of Defense:or
❑Discharge documents
C.❑The assessed valuate of the property for which the deduction is danced(may not exceed 5206,500 $
D.❑The property is the appicant's principal residence.
E.❑The appicant owned the property(«was buying it under contract)brat least one year before the data of this application.
SECTIONS IV.V,AND VI ARE ON REVERSE SIDE
SECTION IV-Surviving Spouse of a World 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 buying it under contract that provides that the applicant is to pay the properly
taxes,which contract,or a memorandum of the contract.is recorded in the County Recorder's office.
Record number Page
e.❑ Applicant has applied or linens to apply for one or more of these deductions on other property in this county or in another county.
❑Yes ❑No Amount S
Canty Taxing aistr a
Second county Taxing dis
r1Ncetoy'l—)
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 Ned(mon/y�day.ye r)
correct.The intentional inclusion of false information on this form is LD_ I
a criminal violation under IC 6-1.1-37-3 or 4. signior coup, ty vud�to(
Tune^r, r tegai reprt•m Na r camIRaa_uucluoorrgyred or careen)
I!` /e V` 11.1er•r• mith
VETERAN DEDUCTION WORKSHEET
20 20 20
1. Total Disability(512.480)
2. Partial disability(524,960)
3. Won Veteran(518.720)
4. 1MM surviving spouse(518,720)
5. Total deduction available(add knes I,2,3 and 4) I
6. Amount applied to real estate key number
7. Amount applied to personal property duplicate number
8. Amount applied to motile home duplicate number I
9. Total deduction applied to taxable property(add knes 6,7 and 8)
10. Deduction available for excise-(sabt2dt 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.