Veterans_Buchannan (2) APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
:! `T WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS •
j State Form 12662(R131 S-7.3t)of T y�
/ Prescribed by 1266e1.20.(%413 survive '
INSTRUCTIONS: Please check appropriate boxes)per3itirg to fax deduction.(More Nan one box may be checked;however, S use h
receives a deduction under Segcn IV may not receive a deduction under Section It)
FILING DATES: (`[p �r
REAL MOBILE RHOOMES(IC 6-11..1--G OR MANUFACTURED HOMES NOT ASSESSED AS REAL PROPERTY:DURING THE TWELVE(12)MONTHS BEFARO 2014
MARCH 31 OF EACH YEAR FOR WHICH THE INDMDUAL WISHES TO OBTAIN THE DEDUCTION.
❑I Totally disabled veteran(or veteran at least age 62 with at leas 1054 disability)or surviving spouse-Not to exceed 512,�p
Complete sections I,V and M. (IC 6-1.1-12-14)
❑II Partially service-connected disabled veteran or surviving spouse-Not to exceed$24,960 GIBSOIIN��CO:-LU�'J)T{YAUDITOR
Complete sections II,V and VI. (IC 6-1.1-12-13)
❑III World War I Veteran-Not to exceed 518,720
Complete sections III,V and VI. (IC 6-1.1-12.17.4)
❑IV Surviving spouse of World War I Veteran-Not to exceed 518,720
Complete sections IV.V,and VI. (IC 6-1.1-12-16)
Na f app&.ant(finr,m'de,last)
•
Amu)number street city state,and zl ) i
Applicant oes on not) own property with another individuals)besides spouse and/or another veteran.
This application is made for the purpose of obtaining 5 deduction from the assessed valuation of the following described taxable
properly for the year 20 . (If applicant desires that deduction be split among additional properties,ash those properties on additional sheet and attach
it to this application)
,w Distrct tary.town.township) I Is the rrcpe,y in question: Parcel or Key number
s-cr v i7 �T^eal Property El Mobile Home(IC 6-1.1-7) I -l1- bl- o • 000.`l 0�'Oelg
A❑Applicant was a member of the U.S.Arched Fortes for at least 90 days(not necessarily during war:me).
B.❑Appicem was luanetfy discharged.
C.❑Applicant ts: ❑Totally disabled;or
❑At least age 62 with at least 10%6sabity
D.❑Applicant's disabity is evidenced by ❑Certscate of eligibility from the Indiana Department of Veterans Arais;
❑Pension certificate;
❑Award of compensation from Veterans Administration or Deparlment of Defense:or
❑Veterans Administration Forth 20-5455'Tax Abatement Certificate
E.❑The assessed value of al of the tangible property the appican owns does not exceed 5143.160. Deductions dawned$
F.❑Applicant is the surviving spouse of an indMdual who would have guatied for the deduction under this section when he or she was aFre.
(Age of deceased veteran on date of dead)
. . '_. • . .. - SECTION II -Partial Disability •
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 at least 10%
D.❑Applicant's disability is evidenced by: renificate of eligibility from the Indiana Department of Veterans Affairs;
❑Pension certificate;
❑Award of compensation from Veterans AdoNnbbation 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 for the deduction under this section when he or she was alive.
(Age of deceased veteran on date of death
• . SECTION 111 -World War I Veteran
A❑Applicant is a veteran of Work War I.
B.❑Applicants service is evidenced by. ❑Leiser from Veterans Ad,untre.I or Department of Defense:or
❑Discharge doamrents
C.❑The assessed valuation of the property for whi h the deduction Is dxined(may not exceed 5206,50) S
D.❑The property is the appiala's pindpal residence,
E.❑The applicant owned the Pronely(or was buying it under comsat)far at least tiro year before the date of his application.
SECTIONS 114 V,AND VI ARE ON REVERSE SIDE -
SECTION IV -Surviving Spouse of a World War I Veteran
A.0 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 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 ,axing district
Second county I Taxing direct
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 feed(month,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. Signature of county auditor
signa:cre t econ- torte_9al re sentat. Name of county auditor(typed arnwfen)
VETERAN DEDUCTION WORKSHEET .,.
20 20 20
I. Total Disability 012,480)
2. Partial disability($24.960)
3. VNII Veteran(518.720)
4. VMI surviving spouse(518,720)
5. Total deduction available(add lines 1,Z 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:mm 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.