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Home My WebLink AboutVeterans_Power IL s APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, 4', WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS , State Farm 12567(R13/5-13) Proscribed by the Department of local Government Finance INSTRUCTIONS: Reese 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. MOBILE i MOBILE HOMES(IC 6-1.1-7)OR MANUFACTURED HOMES NOT ASSESSED AS REAL PROPERTY:DURING T tae: MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DEDUCTION. CI Totasy disabled veteran(or veteran a:least age 62 with at least 10%disability)or sunivIng spouse-N9((o.n2n$12`80 Complete sections I.V and VI. (IC 6-1.1-12-14) J C r' /, L ❑II Partially seryce-connected disabled veteran or surviving spouse-Not to exceed$24,960 Complete sections II,V end VI. (IC 6-1.1-12-13) n, ❑III World War I Veteran-Not to exceed 318.720 v I�,,,, Complete sections III.V and VI. (IC 6-1.1-12-17.4) NNNiii"'ggg///KKµ ❑IV Surviving spouse of World War I Veteran-Not to exceed$18,720 GIBSON COUNTY AUDITOR Complete sections IV,V.and A. (IC 6-1.1.12-16) -. _ . Name a ,', -._ ' Moms(num or and• 1 MPa.:ft,end 2lPCad) County 10 10 • �-{`1111a(yS+' Pr1nCaibni� t47c, . Gibson Applicant ( as ❑does not) own property with another individuals)besides spouse andlor another veteran. This application Is made for the purpose of obtaining$ deduction from the assessed valuation of the following described taxable properly for the year 20 . (If applicant desires that deduction be split among additional properties,1st those prope2'es on additional sheet and attach it to this application) • - . T strict(cry,town,l wn4Np) I}ss the reopen),n question: outlier or Key number rIn(1 n1 triReaProperty ❑Mcrae Home(IC 61,1-7) I ab-tar 1$ •c3•D/-Cb1•1 � A.❑Applicant was a ember of the U.S.Abed Faces for at least 90 days(not necessarily during war tme). B.❑Applicant was honorably discharged. C.❑Applicant is: ❑Totally disabled;or ❑Al least age 62 with at least 10%disabby a❑Appicanl s disability is evidenced by ❑Certificate of eligibility horn the Indiana Delar4tiont of Veterans Awa'us: ❑Pension certi5rate; ❑Award of compensation than Veterans Administration or Department of Defense;or ❑Veterans Admulisuation Form 20-5455'Tax Abatement Certificate E.❑The assessed value of al of the tangible property the applicant owns does not exceed$143,160. Deductions claimed 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 dye. (Age of deceased veteran on date of death_ ) ._ - _ - c� _ SECTION0 -PaNal Disability. _ _ _- A❑Applicant was a member of the U.S.Armed Forces during any of its wars. B. licant was honorably discharged. C Applicant has a service connected disability of at least 10% 0 Appicanl's disabdiry is evidenced by: f.Cerbacate of eligibility tram the Indiana Department of Veterans Affairs; Pension certificate; ❑Award of compensation from Veterans Administration or Department of Defense;or ❑Veterans Administration Form 245455'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 III -World War I Veteran - A❑Appiwa is a veteran of World War I. B.❑Applicant's service a evidenced by ❑Lever from VeteransAdnvvs:man or Department of Defense:or ❑Distharge documents C.❑The assessed valuation of the property for which the deduction Is darned(may not exceed 5206,500) 3 D.❑The property is the applicant's principal residence. E.❑The applicant owned the property(or was buying if under contract)for at least one year before the date of his app6cavon, . SECTIONS IV,V,AND VI ARE ON REVERSE SIDE , :. . . . - RECEIPT FOR APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERAN,WWI 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: ��'�� I/rr��{{{ 1 f�❑SECTION I (/�J SECTION II ❑SECTION III ❑SECTION IV /� �/4\/T�� {��j/�J I: f n:(first. �V f I ,k `p/\..T 1 �� fxvt Name "d1 V to-/& • in - i IPartel110—Y"" —`188n-80//--coI..x1i a-oa I Date l yLdaf,yea _i a I SECTION IV -Sunning Spouse of a World War I Veteran , A.0 Applicant is the surviving spouse of an individual who served in the U.S.Arched 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 conuact,or a memorandum of the contract,is recorded in the County Recorder's 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 p•No Amount$ County Taxing dis:n ct Second county ITaxing dishad 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(mown,day yea correct.The intentional inclusion of false information on this form is . —C I—Iµj -- . a criminal violation under IC 6-1.1-37-3 or 4. Signature of noun *tor �'_rl r r f/LI / �'v YSign of applicant or legal re sennlatavee Name of county auditor orti 7 VETERAN DEDUCTION WORKSHEET 20 20 20 1. Total Disability($12,480) I 2. Partial disability(524,960) 3. WJd Veteran($18720) 4. WA/l surviving spouse(518.720) 5. Total deduction evadable(add lines I,2.3 and 4) 6. Amount applied to real estate key number I 7. flaunt applied to personal property duplicate number • B. Amount applied to mobile borne duplicate number I 9. Total deduction applied to taxable property(add tines 5,7 and 8) 10. Deduction evadable for excise'(subtract line 9 from kne 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. •