HomeMy WebLinkAboutVeterans_Deal A .. APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
C/ .t%\ WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS •
J State Form 12662(R12/5-12)
ar ° 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 Il.)
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: DURING THE TWELVE (12)MONTHS
BEFORE MARCH 31 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DE
❑ I Totally disabled veteran(or veteran at least age 62 with at least 10%disability)or surviving s - t to a e1 • t:0
Complete sections I,V and VI. (IC 6-1.1-12-14)
❑ II Partially service-connected disabled veteran OR surviving spouse-Not to exceed 524,960 MAY 2 2 201
Complete sections II,V and VI. (IC 6-1.1-12-13)
❑ III World War I Veteran-Not to exceed 518,720
mierComplete sections III,V and VI. (IC 6-1.1-12-17.4) ,Ti
❑ IV Surviving spouse of World War I Veteran-Not to exceed 518,720 GIBSON COUNTY AUDITOR
Complete sections IV,V,and VI. (IC 6-1.1-12-16)
— - - • . - •- APPLICANT' - ' .
Name of appf nt(first,middle,last)
Address and nu ate, . wr_d ZIP wde)_ f4 n `'7`3�County
Applicant (0 does ❑does not) own property with another individual(s)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
property for the year 20 .
Taxing District(city,town, township) • . Is the property in question: Parcel o�r�](ey number nn/� p�/�� I�L//��L
❑Real Property ❑Mobile Home(IC 6-1.1-7) , lip -A _p -200- .107 7 t C!�Y
SECTION I:
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$
- County Taxing district
Second county Taxing district
SECTION VI - Application Verification and Auditor Signature's • . - • . - .
I certify that this application was filed in my office.
I certify that the information provided in this application is true and Date filed(month,day year)
correct. The intentional inclusion false information on this form is 5 ' a'lc
a iminal v' lotion u er IC -37-3 or 4. S' n re of county audi\JiN�N►`-
Si ature of applicant or legal presentative
Name of auditor(typed or written)
Zhcrr t Svn ' k
VETERAN DEDUCTION WORKSHEET
20 20 20
t 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$2.00 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.