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HomeMy WebLinkAboutVeterans_Buchannana; y APPLICATION FOR PROPERTY TAX BENEFITS FOR DISABLED VETERAN �I� r AND SURVIVING SPOUSES OF CERTAIN VETERANS State Form 12662 (R20 / 6-26) Prescribed by the Department of Local Government Finance Instructions: Please check appropriate box(es) pertaining to the applicable tax deduction or credit. More than one (1) box may be checked, however, an individual who claims a deduction under Section I may not claim a credit under Section I/ or Section 111 or a deduction under Section V for that same assessment date. (IC 6-1.1-12-14(d); IC 6-1.1-12-14.5(d)) Filing Date: This form must be completed, signed, and filed by January 15 of the calendar year in which the property taxes are first due and payable. File with, the county auditor of the county where the property is located. F I Totally Disabled Veteran or Surviving Spouse — Deduction of 100% of the assessed value of principal place of residence Complete Sections 1, Vl, and VII. (IC 6-1.1-12-14) ❑ II Veteran with Service -Connected Disability or Surviving Spouse — Credit not to exceed $350 Complete Sections 11, VI, and Vll. (IC 6-1.1-51.3-6) ❑ III Veteran at least Age 62 with at least 10% Disability or Surviving Spouse — Credit not to exceed $250 Complete Sections Ill, Vl, and Vll. (IC 6-1.1-51.3-5) ❑ IV Surviving Spouse of World War I Veteran — Deduction not to exceed $18,720 Complete Sections IV, VI, and VII. (IC 6-1.1-12-16) ❑ V Deduction for Homestead Donated to Veteran Complete Sections V, VI, and VII. (IC 6-1.1-12-14.5) APPLICANT INFORMATION Name of Applicant (first, middle, last) Buchannan, Venice Date of Birth (month, day, year �,II 6 CM Telephone Number �� ��q-� " Address (number and street, city, state, and ZIP code) County Email Address 220 E Clark St Princeton, IN 47670 Gibson Applicant (❑ does ❑ does not) own property with another individual(s) besides spouse and/or another veteran. This application is made for the purpose of obtaining $ deduction from the assessed valuation of the following described taxable property and/or $ credit against local property taxes imposed on the following described taxable property for the year 20 (If applicant desires that a credit be split among additional properties, list those properties on additional sheet and attach it to this application. deductions under Section I and Section V may only apply to the applicant's homestead property.) 0e c.,.. n—f-f ­toAn townships% I Ic fhp nrnnprty in nupstiore I Parcel or Kev Number rinceton ® Real Property ❑ Mobile Home (IC 6-1.1-7) 1 26-12-07-401-000.704-028 A. ❑ Applicant served in the military or naval forces of the United States for at least ninety (90) days (not necessarily during war time). B. ❑ Applicant was honorably discharged. C. ❑ Applicant has a total disability. D. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility (Section VIII) from the Indiana Department of Veterans Affairs ("IDVA") after IDVA has determined that the individual's disability qualifies the individual to receive a deduction under IC 6- 1.1-12-14; ❑ Pension certificate from the U.S. Department of Veterans Affairs; or ❑ Award of compensation from U.S. Department of Veterans Affairs E. ❑ Applicant has resided in Indiana for at least one (1) year before the assessment date for which this deduction is claimed. F. ❑ Applicant is the surviving spouse of an individual who would have qualified for the deduction under this section when he or she was alive and the applicant has not subsequently remarried. G. ❑ Applicant uses the property on which the deduction is claimed as the applicant's homestead (principal place of residence). A veteran who claims this deduction for an assessment date may not also claim the Homestead Donated to Veteran Deduction under IC 6-1.1-12- 14.5 or receive a local property tax credit under IC 6-1.1-51.3 for that same assessment date. A. ❑ Applicant served in the military or naval forces of the United States during any of its wars. B. ❑ Applicant was honorably discharged. C. ❑ Applicant has a service -connected disability of at least 10% or more. D. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility (Section VIII) from the Indiana Department of Veterans Affairs ("IDVA") after IDVA has determined that the individual's disability qualifies the individual to receive a credit under IC 6-1.1- 51.3-6; ❑ Pension certificate from the U.S. Department of Veterans Affairs; or ❑ Award of compensation or disability compensation check from U.S. Department of Veterans Affairs ❑ Applicant is the surviving spouse of an individual who would have qualified for the credit under this section when he or she was alive. 4�. Page 1 of 2 SECTION III — VETERAN AT LEAST AGE 62 WITH DISABILITY OF 10% OR MORE CREDIT A. ❑ Applicant served in the military or naval forces of the United States for at least ninety (90) days (not necessarily during war time). B. ❑ Applicant was honorably discharged. C. ❑ Applicant is at least age 62 with at least 10% disability. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility (Section VIII) from the Indiana Department of Veterans Affairs ("IDVA") after IDVA has determined that the individual's disability qualifies the individual to receive a deduction under IC 6- 1.1-12-14; ❑ Pension certificate from the U.S. Department of Veterans Affairs; or ❑ Award of compensation from U.S. Department of Veterans Affairs E. ❑ Applicant is the surviving spouse of an individual who: (1) would have qualified for the credit under this section when he or she was alive; or (2) was killed in action, died while serving on active duty, or died while performing inactive duty training. (Age of deceased veteran on date of death ) SECTION•• OF •- . WAR I VETERAN A. ❑ Applicant is the surviving spouse of an individual who served in the military or naval forces of the United States before November 12, 1918. B. ❑ The service of the deceased spouse is evidence by: ❑ Letter from the U.S. Department of Veterans Affairs; or ❑ Honorable discharge documents C. ❑ The deceased spouse received an honorable discharge. SECTION V — DEDUCTION FOR HOMESTEAD DONATED TO VETERAN A. ❑ Applicant served in the military or naval forces of the United States for at least ninety (90) days. B. ❑ Applicant was honorably discharged. C. ❑ Applicant has a disability of at least 50%. D. ❑ Applicant's disability is evidenced by: ❑ Pension certificate or an award of compensation issued by the U.S. Department of Veterans Affairs; or ❑ A certificate of eligibility (Section VIII) issued to the individual by the Indiana Department of Veterans' Affairs ("IDVA") after IDVA has determined that the individual's disability qualifies the individual to receive a deduction under IC 6-1.1-12-14.5 E. ❑ Applicant's homestead was conveyed without charge to the applicant who is the owner of the homestead by an organization that is exempt from income taxation under the federal Internal Revenue Code. The amount of the deduction is determined as follows: 1. If the applicant is totally disabled, the deduction is equal to 100% of the assessed value of the homestead. 2. If the applicant has a disability of at least 90% but is not totally disabled, the deduction is equal to 90% of the assessed value of the homestead. 3. If the applicant has a disability of at least 80% but less than 90%, the deduction is equal to 80% of the assessed value of the homestead. 4. If the applicant has a disability of at least 70% but less than 80%, the deduction is equal to 70% of the assessed value of the homestead. 5. If the applicant has a disability of at least 60% but less than 70%, the deduction is equal to 60% of the assessed value of the homestead. 6. If the applicant has a disability of at least 50% but less than 60%, the deduction is equal to 50% of the assessed value of the homestead, veteran who claims this deduction for an assessment date may not also claim the Totally Disabled Veteran Deduction under IC 6-1.1-12-14 for -that same assessment date. Moreover, an unused portion of this deduction may NOT be applied to excise taxes. SECTION•. • •- • A. ❑ Applicant owns the property on which the deduction or credit 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 (Note that a person applying for a deduction under Section V must own the property.) B. ❑ Applicant has applied or intends to apply for one or more of these credits on other property in this county or in another county. ❑ Yes ❑ No Amount $ County Taxing District Second County Taxing District SECTION• • . AUDSIGNATURE ITOR I certify that this application was filed in my office. Date Filed (month, day, year] -7 � �� I certify that the information provided in this application is true and correct. The intentional inclusion of false information on this form is a 1 criminal violation under IC 6-1.1-37-3 or 4. Signature of county Auditor Suture Applicant or Legs' Representative G� Name of County Auditor (type or wri Michael A Watkins Veter�a 's Military Service IED'Honorable et�ert's character of discharge More than ninety (90) days or Under Honorable Conditions —'/et,pn's type of service (check one) VA disability rating Veteran's date of birth (month, day, year) YWartime service ❑ Peacetime service Accredited IDVA sta or a crtedndi County Veteran Se ic6 Officer signature Date (month, day year) cf�,2� 1 C �� SD D-71 o �' .(0 �,J Page 2 of 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.