Veterans_Cassiday •
APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
State Form 12662(R13/5.13)
Prescribed by tee Department of Local Government Ftrlance
INSTRUCTIONS: Please check appropriate bo+(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 E HOMES(IC DURING THE YEAR FOR WHICH THE S DEDUCTION NOT ASSESSED IS DAS RE.
MOBILE HOMES(IC YEAR OR MANUFACTURED HOMES WISHES OBTAIN IN REAL PROPERTY:DURING THE TWELVE 12 T BEFO
MARCH 31 OF EACH YEAR FOR WHICH THE INDMDUAL WISHES TO OBTAIN THE DEDUCTION.
❑I Totaty disabled veteran(or veteran at least age 62 with of least 10%disabibly)or surviving spouse-Not t 2.
Complete sections I,V and VI. (IC 61.1-12-14)
❑II Complex secdoonss service-connected
V anddisabled
'A.b(IC 61 11-12-13)u p spouse-Not to exceed 524,960 J U L 21 2014
❑III World War I Veteran-Not to exceed 116.720
Complete pousnsfII,V and VI. et r 6-1.1-12-17.4)nN
❑N Surviving spouse of World War I Veteran-Not to exceed f18.720 �IJJYI�D-7-14 Levigct
Complete sections lVV,and Vl. (IC 61.1-12-16) GIBSON COUNTY .TOR
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Applicant (0 does ❑does not) own property with another individual(S)beside y/ppouse and/or another veteran.
This application is made for the purpose of obtaining S deduction from the assessed valuation of the following described taxable
property for the year 20 . (If applicant desires Nat deduction be split among additional properties,list those properties on additional sheet and attach
it to this application.)
Tadn evict Icily,town,township) I Is the property in question: Parcel or Key number
Real Property ❑Mobie Home(IC 6-1.1-7) ,ago ./y.3D -YDO -000./S7 iOO tO
A❑App4ant was a member of the U.S.Armed Farces for at least 90 days(notnerzssanly Curing wartime).
B.❑Applicant was honorably dsdwged.
C.❑Apperant is: ❑Totally disabled;a
At least age 62 with at least 10%dsab lly
D.❑Applicants disabilty is evidenced by. ❑Certificate of eligibility from the Indiana Department of Veterans Affairs;
0 Pension certificate;
N Award of compensation from Veterans Adnmlis ration or Department of Defense;or
❑Veterans Administration Form 20-5455'Tax Abatement Gen/mate'
E.❑The assessed value of al of the tangible property the applicant owns does not exceed 1143.160. Deductions claimed S
F.❑Applicant o the savrtg spouse of an ndMdual who would have qualified for the deduction under tic season Mien he or she was else.
(Age of deceased veteran on date of deadh
SECTION II -Partial Disability .t n '
A❑Applicant was a member 01 the U.S.Armed Forces during any of its wars.
B.❑Applicant was honorably discharged.
C.❑Applicant has a service connected disabsty of at least 10%
D.❑Applicant's disability is evidenced by: ❑Certificate of eligibility Men the Indiana Department of Veterans Affairs;
❑Pension certificate;
❑Award of compensation from Veterans Administration or Department of Defense;or
❑Veterans Administration Farm 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
SECTION 1B -Word War l Veteran
A❑Applicant is a veteran of Vold War I.
6.❑Applicants service is evidenced by ❑Leter from Veterans Adroiistation or Department of Defense;or
❑Discharge doavnents
C.❑The assessed valuation of the property forwNah the deduction is claimed(may not exceed$206,500) S
D.❑The property is the applicants principal residence.
E.❑The applicant owned the property(or was buying it undercontrsa)for at least one year before the date of tis appacaton.
SECTIONS IV,V,AND VI ARE ON REVERSE SIDE .
SECTION IV -Surviving Spouse of a World War Veteran
A.❑ Applicant is the surviving spouse of an individual who served in the U.S.Armed Forces before November 12.1918.
8.❑ The service of the deceased spouse is evidenced by: ❑ Letter from the Veterans Administration or the Department of Defense;or
❑ Honorable discharge documents
C.❑ The deceased spouse received an honorable discharge.
SECTION V -Additional Information
A❑ Applicant owns the property on which the deduction is claimed or is buying it under contract that provides that the applicant is to pay the property
taxes,which contract,or a memorandum of the contract.is recorded in the County Recorder's office.
Record number page
8.❑ Applicant has applied or intends to apply for one or more of these deductions on other property in this county or in another county.
❑Yes ❑No Amount$
County Taxing district
Second county Taxing district
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 ore tied((numb,day fear)
correct.The intentional inclusion of false information on this form is
avaaaiminal violation
s/{under rIIIC 6-1.1-37-3 or 4. Signature of county amarn
S.¢r'ain We .t orlegalrepreun:a;ne Name of county aud,tor(typed or men)
VETERAN DEDUCTION WORKSHEET _..
20 20 20
1. Total Disability(512,480)
2. Partial disability($24,960)
3. MI Veteran(518.720)
4. WWI surviving spouse(518.720)
15. Total deduction available(add lines 1.2.3 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 e) I
ID. 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
($2.00)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.