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HomeMy WebLinkAboutVeterans_Miller (2)APPLICATION FOR PROPERTY TAX BENEFITS FOR DISABLED VETERANS 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 II 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)) t-mng 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. I Totally Disabled Veteran or Surviving Spouse — Deduction of 100% of the assessed value of principal place of residence ttt 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 It, VI, and VII. (/C 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 VII. (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) Date of Birth (mori , day, year) � j Telephone Number T A °, 1 �S ( 1 ) f'T7'-7 123S Miller, William D/Jo ce Address (number and street, city, state, and ZIP codW)V). IAS �2 County Email Address - - - _ --'enjoy--�� `gQ 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. The deductions under Section I and Section V may only apply to the applicant's homestead property.) Taxing District (city, town, townships) Is the property in question: Parcel or Key Number na -- -11 � - tea- ®oy 1 tab-. rnceton M Real Property ❑ Mobile Home (IC 6-1.1-7) � Q .02& 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. Page 1 of 2 SECTIONDISABILITY OF OR MORE 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. ,..f). ❑ 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 •- ■ 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 at 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• • AND AUDSIGNATURE ITOR I certify that this application was filed in my office. Date Filed (month, day, year) I certify that the information provided in this application is true and correct. The intentional inclusion of false information on this form is a Sigq re of Coun /�ito 40 criminal violation under IC 6-1.1-37-3 or -4. Signature of Applicant or Legal Representative Name of County Auditor (typed or written) / 7 Michael A Watkins Veteran's Military Service Vete s character of discharge El More than ninety (90) days L�9 Honorable or Under Honorable Conditions --Iteteran�§,type of service (check one) VA disability rating Veteran's date of birth (month, day, year) Wartime service ❑ Peacetime service (.,1,- •- �iv Accredited IDVA staff or accredited Fft iprfa County Veteran Service Officet $ignature Date (month, day, year) `� Page 2 of 2 "•"o APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, a ' •WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS r. `i State Form 12662(R12/5-12) �i.;. Prescribed by the Department of local Government Finance INSTRUCTIONS: Please check appropriate box(es)pertaining to tax deduction. (More than one box may be checked;however, a surviving spouse who receives a deduction under Section IV may not receive a deduction under Section 11.) FILING DATES: REAL PROPERTY: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT. MOBILE HOMES(IC 6-1.1-7)OR MANUFACTURED HOMES NOT ASSESSED AS REAL PROPERTY: 0 I Ili TF}$E TAFV: Z�,MONTHS BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DEDUII • �NL J 1 p 6N ❑ I Totally disabled veteran(or veteran at least age 62 with at least 10%disability)or surviving spouse-Not to exceed 5122,480 Complete sections I,V and VI. (IC 6-1.1-12-14) APR 2 4 2015 ❑ II Partially service-connected disabled veteran OR surviving spouse-Not to exceed 524,960 Complete sections II,V and VI. (IC 6-1.1-12-13) ❑ III World War I Veteran-Not to exceed 518,720 1ytiL — Complete sections_III,V and VI. (IC 6-1.1-12-17.4) GIBSON COUNTY AUDITOR ❑ 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) . •- APPLICANT . ' Nam of ap tic t first,middle,last)10 a Addreesstreet and number, city,state, an IP code) Cou�r /) - 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 54 1/4lo G deduction from the . B.❑Applicant was honorably discharged. C.❑Applicant is: ❑ Totally disabled;or ❑At least age 62 with at least 10%disability D.❑Applicant's disability is evidenced by: ❑ Certificate of eligibility from the Indiana Department of Veterans Affairs; ❑ Pension certificate; ❑Award of compensation from Veterans Administration or Department of Defense;or ❑Veterans Administration Form 20-5455-Tax Abatement Certificate' E.p The assessed value of all of the tangible property the applicant owns does not exceed 5143,160. Deductions claimed 5 F. 0 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 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 of a east 10% D.❑Applicant's disability is evidenced by: Certificate of eligibility from the Indiana Department of Veterans Affairs; ❑P sion certificate; Award of compensation from Veterans Administration 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 III = Wodd War I Veteran - - •A. ❑Applicant is a veteran of World War I. B. ❑Applicant's service is evidenced by. ❑Letter from Veterans Administration or Department of Defense;or ❑Discharge documents C.❑The assessed valuation of the property for which the deduction is claimed(may not exceed$206,500) 5 D. ❑The property is the applicant's principal residence. E. 0 The applicant owned the property(or was buying it under contract)for at least one year before the date of this application. . • - • - - •� SECTIONS N,V,AND VI ARE ON REVERSE SIDE ' •- V •• - 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 property taxes, which contract,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 ❑ No Amount S County Taxing district Second county Taxing district SECTION VI - Application Verification and Auditor Signature ■ I certify that this application was [-. i i .ffc: I certify that the information provided in this application is true and Date fled(month, day,year) ^ �J ' correct. The intentional inclusion of false information on this form is 6'a 1_44 2 4 2015 a c ,ml'nal violation under IC 6-4.1-3 3 or 4. Signatur ��f unty auditor Si ature of applicant or legal representative Name of county auditor(type or written S h ter r t sertaigt SN COUNTY AUDITOR • VETERAN DEDUCTION WORKSHEET 20 20 20 1. Total Disability($12,480) 2. Partial disability($24,960) 3. WWI Veteran($18,720) 4. WWI surviving spouse($18,720) 5. 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 8) 10. 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) calculated at S2.00 per$100.00 for cars and for aircraft [see 6-6-6.5-13(e)) of unused veteran's deduction. The information contained on this form is CONFIDENTIAL according to IC 6-1.1-35-9.