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Home My WebLink AboutVeterans_Kinsall APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, / �� I,VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS ��/J' W�N State Fomi 62(R8/4-04) \•,• Prescribed by the artment of Local Government Finance IMCTRUCTIONS: Please check propriate 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 II.) _NG DATES: REAL PROPERTY: DURING THE 12 MONTHS BEFORE MAY 11 OF THE YEAR THE DEDUCTION IS TO APPLY. MOBILE HOMES(6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DEDUCTION. ❑ I Totally disabled veteran(or veteran at least age 62 with at least 10%disability)or surviving spouse-Not to exceed 512,480 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 Complete sections II,V and VI. (IC 6-1.1-12-13) ❑ III World War I Veteran-Not to exceed$18,720 Complete sections III,V and VI. (IC 6-1.1-12-17.4) ❑ IV Surviving spouse of World War I Veteran-Not to exceed 618,720 Complete sections IV,V,and VI. (IC 6-1.1-12-16) APPLICANT Name o plirant(first,middle,last) Address(street and number,city,state,ZIP code) (� C tq�y It a% l�.IJU Ain cwt.. @-t . %D`t t 416 7 0 X71 ,e.`,�__� 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 S°?4/ 9eo O j 1/t deduction fro eassesssed va aQr th following.' cn�taxa a r 501.1, la of l property for the year 20� � • Taxing;i�( ity, •wn,tow-- ip) q Is the •roperty in question: Parcel or Key number �� -_•. , , 1Q 3- tie-I Property ❑ Mobile Home(IC 6-1.1-7) ' -.SECTION I - Total Disability OR at least age 62 with at least 10 disability Applicant was a member of the U.S.Armed Forces for at least 90 days(not necessarily during -r tiro- . • B. ❑ Applicant was honorably discharged. • 44 C. Applicant is: 0 Totally disabled;or - A way'•�j� „az v mtv, ❑ At least age 62 with at least 10%disability S D. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility from the Indiana Department of - -• Affairs; ❑ Pension certificate; ❑ Award of compensation from Veterans Administration or Department of Defense;or ❑ Veterans Administration Form 20-5455"Tax Abatement Certificate' E. ❑ The assessed valuation(at 100%)of the property for which the deduction is claimed(may not exceed$113,000) 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 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 at least 10% D. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility from the Indiana Department of Veterans Affairs; ❑ Pension certificate; V❑ ward of compensation from Veterans Administration or Department of Defense;or eterans 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 --World War I Veteran A ❑ Applicant is a veteran of World War I. 4107 Applicant's disability is evidenced by ❑ Letter from Veterans Administration or Department of Defense;or ❑ Discharge documents ' C. ❑ The ass seed valuation(at 100%)of the property for which the deduction is claimed(may not exceed$163,000) $ D. ❑ The property is the applicant's principal residence. E. ❑ The applicant owned the property(or was buying it under contract)for at least one year before the date of this application. SECTIONS IV,V, AND VI ARE ON REVERSE SIDE • • - 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. - ` •a , B. ❑ The services 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 certi that this application was filed in my office I certify that the information provided in this application is true and Date files L correct.The intentional inclusion of false information on this form is a ;�`_��;,) criminal violation vviiolationnaunder IC 6-1.1-37-3 or 4. Signature of county auditor -gatutzntor lere ,e Mud 21 or written) wn o71aie • ' VETERAN DEDUCTION WORKSHEET U 20 20 20_ 1. Total Disability(512,480) 2. Partial disability($24,960) 3. WWI Veteran($18,720) 4. WW1 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- 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. . . . . ._.