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HomeMy WebLinkAboutVeterans_Smith (2) DEPARTMENT OF VETERANS AFFAIRS t- "' ,:.:.S. CERTIFICATE OF ELIGIBILITY 777 North Meridian Street, Suite 300 ifrile.,z DISABLED VETERAN TAX DEDUCTION Indianapolis, Indiana 46204-1421 `\'. '/ State Form 51186 (R6 / 7-20) Telephone: (317) 232-3910 Fax: (317) 232-7721 ' This agency is requesting disclosure of your Social Security Number in accordance with IC 4-1-8-1 ; disclosure is mandatory and this record cannot be processed without it. Name of veteran (last, first, middle) SMITH JOE BOB Date of Birth (month, day, year) Is the Veteran Deceased? Date of Death (month, day, year) 10/19/1949 ; ... Yes L No Veteran's Social Security Number * Veteran's Service / Serial Number Veteran's VA File Number 312520846 Name of surviving spouse (last, first, middle) (Required only if veteran is deceased.) Telephone number E-mail address 812 483-7755 Property Mailing Address (number and street, city, state, and ZIP code) 2578 E. TOPHAT RD. PRINCETON IN 47670 Mailing address where form to be sent if different than property (i.e. CVSO, County Auditor/Assessor) Sig ature of veteran I su '"•n • ized agent Date (month, day, year) ,4 � 41=1 , . ` . 4) 12/10/2025 Il In deter ; eligibility for the Disabled Veteran Tax Deduction benefit, the Indiana Department of Veterans' Affairs (ID A verifies the veteran's period of military service, United States Department of Veterans' Affairs disability rating, and date of birth. The County Auditor will determine further eligibility for this benefit based on Indiana Code 6-1 .1 -12-13, 6-1 .1 - 12-14 or 6-1 .1 -12-15 and 6-6-5-5, 6-6-5-5.2. Once this form is complete with IDVA verification, it must be taken to the appropriate County Auditor for final determination of benefit and processing. FOR IDVA VERIFICATION ONLY Veteran's beginning date of service (month, day, year) Veteran's ending date of service (month, day, year) 08-05-1969 03-09-1971 Veteran's beginning date of service (month, day, year) Veteran's ending date of service (month, day, year) Veteran's beginning date of service (month, day, year) Veteran's ending date of service (month, day, year) Veteran's beginning date of service (month, day, year) Veteran's ending date of service (month, day, year) Type of service (check one) VA disability rating Veteran's date of birth (month, day, year) Wartime service Li Peacetime service XIC' ,q4iy ID A verification ure Date (month, day, year) i.) 1 c4 y 11 G 12/10/2025 **•-•A Tax deduc on mount el% For County Auditor Use Only/ c - ( Cr--- 17/lit Zo J . 1 V /J f J (t° I lc (/\ ) e I, • ( 1 / l 411 '"."V4 DEPARTMENT OF VETERANS AFFAIRS CERTIFICATE OF ELIGIBILITY 302 West Washington St. DISABLED VETERAN TAX DEDUCTION Indianapolis. IN 46204-2738 -., ' State Form 51186(R5 j 11-13) Telephone (317) 232-3910 • Fax_ Fax. (317) 232-7721 _�_ This agency is requesting disclosure of your Social Security Number in accordance with IC 4-1-8-1 . disclosure is mandatory and this record cannot be processed without it Name of veteran (last. first, middle) SMITH, JOE BOB Date of Birth (month, day, year) Is the Veteran Deceased? Date of Death (month, day, year) 10/19/1949 ❑ Yes M No i 1 Veteran's Social Security Number * Veteran's Service / Serial Number Veteran s VA File Number I 312-52-0846 312520846 i Name of surviving spouse (last, first, middle) (Required only if veteran is deceased.) N/A i Telephone number - _ ____ 0 te ( is t ress --- �'i 812 483-7755 Property Mailing Address (number and 2554 E. TOPHAT RD, PRINCETO Mailing address where form to be sent i i Brent tnd,i pi LNc..., ,.. unty Auditor/Assessor) I — Sign--: re of veteran / sur ng spou- - -.: agent Date (month, day year) ---i 44% i I 3/2/2020 Il In determi • ! eligibility for the Disabled Veteran Tax Deduction benefit. the Indiana Department of Veterans' Affairs (IDVA) verifies the veteran's period of military service. United States Department of Veterans Affairs disability rating. and date of birth. The County Auditor will determine further eligibility for this benefit based on Indiana Code 6-1 1-12-13, 6-1 1- 12-14 or 6-1.1-12-15 and 6-6-5-5. 6-6-5-5.2. Once this form is complete with IDVA verification, it must be taken to the appropriate County Auditor for final determination: of benefit and processing. FOR IDVA VERIFICATION ONLY Veteran's beginning date of service (month, day, year) ' Veteran's ending dale f service (month, day year) Y( Sr—1 ( q C61 43 9 fq 7 I Type of service. (check one) VA disability rating Veteran's date of bi h (month, day, year) Wartime service 0 Peacetime service Div to i i t IDVA verifi atiorlr - . . +re t �, '(el D e ( 1 month, day, year► , ( c C.-lW i fz [ z.c 1---r.� ''.../ — / fi Tax deduction amount For County Auditor Use Only g • ` UUU � r - Department of Veterans Affairs f ' =, A.J. Celebrezze Federal 'Building �f 1240 East 9th Street '! . i Cleveland, OH 44 99 November 10, 2025 In ' -ply Refer To: 325/LAS/MLA JOE B SMITH CSS XXXXX0846 2578 E TOP HAT RD Smith J B PRINCETON IN 47670 Dear Joe B Smith, This letter is a summary of benefits you currently receive om the Department of Veterans Affairs (VA). We are providing this letter to disabled Veterans to e in applying for benefits such as state or local property or vehicle tax relief, civil service preference, to obtain housing entitlements, free or reduced state park annual memberships, or any other pro l m or entitlement in which verification of VA benefits is required. Please safeguard this important d• ument. This letter is considered an official record of your VA entitlement. Our records contain the following information: Personal Claim Information Your VA claim number is:VOCXXX846 You are the Veteran. Military Information The character(s) of discharge and service date(s) of the vets ran include: Honorable, Army, 08/05/1969-03/09/1971 (There may be additional periods of service not listed abov-) VA Benefits Information Service-connected disability: Yes Your combined service-connected evaluation is: 10% count is: $175.51 1 Z'1 l of disability due to being •employable: No 2 and permanently disabled I ue to your service-connected disabilities: 00 ,001 , Z1g Dui?. )ss of or loss of use of a li ii b, or areyou totallyblind in or missingat ►dapted Housing (SAH) an or Special Home Adaptation (SHA) grant: r local office of veterans' . i airs for information on any tax, license, or )_C‘ — )u may be eligible. State o hi ces of veterans' affairs are available at w c11--- CI - r \- -- cam- -- 0 citzill.kibit.,\31__L . . LA - 1 ... .• 1 5-c-rycl 11,-- -1 (-- 414 - 1 • -7 0 . z: :� •.• 02 EDUCTION FOR DISABLED VETERANSe34 1vv ��'~.g._ �sPPLICATlO r ` -;`:.:1 • AND SURVIVING SPOUSES OF CERTAIN VETERANS r-r- 48 , ' !): State Form 12662 (R16/ 1-17) - 1' Prescribed bythe Department of Local Government Finance roes o s o allm 'UCTIONS: Please check appropriate box(es) pertaining to tax deduction. (More than one ( ox may be checked; however, a surviving spou c receives a deduction under Section Ill may not receive a deduction under Section II.) FILING DATES: REAL PROPERTY: FORM MUST BE COMPLETED AND SIGNED BY DECEMBER 31 AND FILED OR POST AR4441_4111,4911!ANUARY 5. 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 DEDUCTION. FILE WITH THE C TY AUDITOR OF THE COUNTY WHERE THE PROPERTY IS LOCATED. 4CMP I Totally disabled veteran (or veteran at least age 62 with at least 10% disability) or surviving spouse - Not to exceed $12,480 omplete sections I, V and VI. (IC 6-1.1-12-14) • Partially service-connected disabled veteran or surviving spouse - Not to exceed $24,960 I S ill Complete sections II, V and VI. (IC 6-1.1-12-13) ~' (1 III Surviving spouse of World War I Veteran - Not to exceed $18,720 Complete sections III, V, and VI. (IC 6-1.1-12-16) - 1Q , -2' \ S H IV Deduction for homestead donated to veteranSR (� J Complete Sections IV, V, and VI. (IC 6-1.1-12-14.5) APPLICANT Name elicant (first, middle, last} Date of f e (m th, day, year) ofAQ c-gp`a ,s nINs - JI 2 0 Address (number and street, city, state, and ZIP code) County Applicant (❑ does I1 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 for the year 20 2)0 . (If applicant desires that deduction be split among additional properties, list those properties on additional sheet and attach it to this application.) Taxing District (city, town, township) 1 th-.property in question: Parcel or Key number ? �P' Real Property I I Mobile Home (IC 6-1.1-7) "�2--`5-10(0'- 0 0, •S IS —0 23- SECTION I - TOl AL DISABILITY OR AT LEAST AGE 62 WITH AT LEAST 10%AT-Dplicant was a member of the U.S.Armed Forces for at least ninety(90) days (not necessarily during war time). �� plicant was honorably discharged. � �, �T � "�- (,( Applicant is: T ly disabled; or AlO ) �G.JI �l (k At least age 62 with at least 10% p 1 , disability 1 Yl -), ' D. ❑ Applicant's disability is evidenced by: n Certificate of eligibility from the Indiana Department of Veterans Affairs; ' 1:14pension certificate; Award of compensation from Veterans Administration or Department of Defense; or I I Veterans Administration Form 20-5455 "Tax Abatement Certificate" E. ;_J The assessed value of the applicant's Indiana real property, Indiana mobile home not a csedAs real property, and Indiana manufactured home not assessed as real property does not exceed $175,000. Deductions claimed $ Ci 6 _ 1 F. I I 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 servi : • o -cted disability of at least 10% D. ❑ Applicant's disa t s - 'd ced by: I I Certificate of eligibility from the Indiana Department of Veterans Affairs; \4•! C4:) Q� ❑ Pension certificate; \ -v-\.\,...4 O ❑ Award of compensation from Veterans Administration or Department of Defense; or �\ meD 'L I I Veterans Administration Form 20-5455 "Tax Abatement Certificate" _ E. I Applicant is tMsA g spo re an individual who would have qualified for the deduction under this section when he or she was alive. (Age of de:"-sed vetera` oA ..to of . . ) SECTION III - SURVIVING SPOUSE OF A WORLD WAR I A. ❑ Applicant is t .1 ei j4,,k ig spouse of an individual who served in the U.S. Armed Forces before November 12, 1918. r The seryike' kN e deceased spouse is evidenced by: r l Letter from the Veterans Administration or the Department of Defense; or C� [ I Honorable discharge documents I The deceased spouse received an honorable discharge. A person may not claim this deduction in conjunction with the partially disabled veteran deduction. SECTIONS IV, V, AND VI ARE ON REVERSE SIDE Page 1 of 2 RECEIPT FOR APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERAN OR SURVIVING SPOUSE OF CERTAIN VETERANS SECTION IV - DEDUCTION FOR HOMESTEAD DONATED TO VETERAN 1. Applicant served in the military or naval forces of the United States for at least ninety (90) days; 2. Applicant received an honorable discharge; • 3. Applicant has a disability of at least 50%; " + 4. Applicant's disability is evidenced by: . A. a pension certificate or an award of compensation issued by the United States Department of Veterans Affairs; or B. a certificate of eligibility 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 this new statue; and 5. Applicant's homestead was cgnveyed witthout•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 tetally disabled, the deducti4 n is equal to 100% of the assessed value of the homestead. ., 2. If the applicant has a disaOlit'y.dtf at !eat/ 90°/!but the individual is not totally disabled, the deduction is equal to 90% of the assessed value of the homtead. ' 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 applicantshas a disability of at least 7(3% but less than 80%, the deduction is equal to 70% of the assessed value of the homestead. 5. If the applicanthas 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 applica'hthas`a disability of at least 56% but less than 60%, the deduction is equal to 50% of the assessed value of the homestead. A veteran who claims this deduction for an assessment date may not also claim a partially disabled veteran deduction or totally disabled veteran deduction under IC 6-1.1-12-13 or 14, respectively, for that same assessment date. Moreover, an unused portion of this deduction may NOT be applied to excise taxes (See the Veteran Deduction Worksheet portion of this form.). SECTION V - ADDITIONAL INFORMATION • A. 0 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 (Note that a person applying for a deduction under Section IV must own the property.) B. 0 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 El No Amount County Taxing district Second countydistricl SECTION VI -.APPLICATION VERIFICATION AND AUDITOR SIGNATURE certify that this application was filed in my office. I certify that the information provided • . Date filed ( onth. , year) correct. The intentional inclusion of false information on this form is 2 2;0 - ____ a criminal violation • • IC • or i Signal coup audit r �.5v 'i-A4-- - ' I _ - �� Name of county di or(typed or written) VETERAN DEDUCTION WORKSHEET 20 20 20 1. Total a ability ($12,480) - 2. Partial disability ($24,960) 3. WWI surviving spouse ($18,720) (Cannot be claimed in conjunction with the totally disabled veteran deduction.) 4. Homestead donated to veteran (Can be applied only to homestead applicant owns; cannot be claimed in conjunction with partial disability or total disability deductions.) 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 i *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 ($2.00) on each one hundred dollars ($100.00) 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. However, unused portion of deduction for donated homestead may not be applied toward excise taxes. For more information, see IC 6-6-5-5 and IC 6-6-6.5-13. Page2of2 - .•lk ",r.o, DEPARTMENT OF VETERANS AFFAIRS 1 - 1, CERTIFICATE OF ELIGIBILITY 302 West Washington St. ii y DISABLED VETERAN TAX DEDUCTION Indianapolis, IN 46204-2738 ll ' r, State Form 51186(R5/ 11-13) Telephone: (317) 232-3910 • .41.• -• Fax: (317) 232-7721 * This agency is requesting disclosure of your Social Security Number in accordance with IC 4-1-8-1 disclosure is mandatory and this record cannot be processed without it. Name of veteran (last, first, middle) SMITH, JOE BOB Date of Birth (month, day, year) Is the Veteran Deceased? Date of Death (month, day, year) 10/19/1949 ❑ Yes j No Veteran's Social Security Number ' Veteran's Service / Serial Number Veteran's VA File Number 312-52-0846 312520846 Name of surviving spouse (last, first, middle) (Required only if veteran is deceased.) N/A Telephone number E-mail address 812 483-7755 Property Mailing Address (number and street, city. state, and ZIP code) 2554 E. TOPHAT RD. PRINCETON. IN 47670 Mailing address where form to be sent if different than property (i.e. CVSO. County Auditor/Assessor) 1 I Sign 7 ure of veteran / su tiiiiorg spous-gh- - • agent Date (month, day, year) d _ 11111i 3/2/2020 ��� - '�" In determi . ! eligibility for the Disabled Veteran Tax Deduction benefit, the Indiana Department of Veterans' Affairs (IDVA) verifies the veteran's period of military service. United States Department of Veterans' Affairs disability rating. and date of birth. The County Auditor will determine further eligibility for this benefit based on Indiana Code 6-1 .1-12-13, 6-1 .1- 12-14 or 6-1 .1 -12-15 and 6-6-5-5. 6-6-5-5.2. Once this form is complete with IDVA verification, it must be taken to the appropriate County Auditor for final determination of benefit and processing. FOR IDVA VERIFICATION ONLY Veteran's beginning date of service (month, day, year) Veteran's ending date f service (month, day. year) Y I CI i q 6,9 9 /iq I Type of service (check one) VA disability rating Veteran's date of bi h (month, day, year) Wartime service ❑ Peacetime service / 0 0 G op ( i ccy "Th IDVA verifi do re r D 9onth, day, year) - r C- 1C i 3 _ Za i , , Tax deduction amount For County Auditor Use Only ii. liwiall51vu9oo - �J o00 - CI\ n ew . 03 Citop - r 4 L15y0p0 I q g IS (U-S- 11/41 ‘/\d ily `-19L, o 6,, 31- -SL-' \( ''Y' , ___ a-0.As-. "Liot J kO vNc\Ofl" CLL9 . t C ‘ .3SS _ _ _____ „------------I-. Af_1336,..Lit....x.1,13 triL icl..:,......,,L0‘....14\ 0 \INL:rg .x.----- it ----5z-. \.),..\ --w\icirk- * iww, fool ta. .„...tvIga..„ b.g.....4-if..., 0tyy ----- __ •,,,,- a 111.. • 1 ads"4,4:11...;" 2._. 4 I 4 ab , i :4 .1 1 .1 CIWOlkiVINk c41., k IP 30E _ 43-- ' c__, 0, 0_, ,_nimpi -Acc) 1,1:;„ - „:3, f-e%,_,: _.,., ,. _,L 4 ik ( -- - 4 LS ` �j444111C � te- „ , ,.• IN ft � lJ j-----`.-'--4 L...X.IL NJ 6,12 Ir- \ --,,AL.,03,„U4- i -. i 111-N)._.D-4:1-t___4.. Q ..__ \.., _I 1W\'.°1L ('..j CtL4-"{:LRILQ- 7 ' C_711,41 in _ --- 1:-.)5-- ---C V aiik'- ''?-: k- f ,--- L-QA_Q____ 6%--,j2k___ . t 1, If- -'.-- --I'- 4. '' ',1 ,,,,,,-)L: - - - - - - - - ---- -_.€....„.....j \\,.... , ________,..„-------- - ---- __\...ci •_a . 7 Gibson County Correction of Error Yearaq Pay _. .cel Number 2 r - . - ILs ( cz> CQ 1 1- .. 0 . Owner :bc. —F.::.)_. Sen i 1 Location Address c SS rexin_e_aon 131•1 . Reason for change; ateax.sakoz2A1/4„.` OD 3 I ► + ' i % .1/4to‘ , cL.A.s %1/4-0 ‘a ' GAL,MP 4 • ‘)GLL)--$L ." Co P-CA% boc.Aciii_ \2scax.otza, Corrected Corrected Corrected Assessment Land improvement Total Land Improvement Total Homestead $0 ential I $0 $0 L _lesidentlal $0 $0 i $0 Long Term Care $0 $0 Agricultural Non Res XXXXXXXXXXX $o _ XXXXXXXXXXX $0 Apartment $0 - Mobile, XXXXX)Q(X $0 $0 XXX � � Total Assessed $� $0 $0 $0 $0 $0 $0 Preparers Date : Ira - \ \ .-c? , " Y22zesitad a. aritaux) Approved k% • FILED - DEC 1 1 2025 IlLt i i • GIBSON COUNTY AUDITOR Veteran 's Deduction Name: LIO C. 660 rrN4-1 Parcel Number: ate. " � �o — 1S— t CO CO ] - I - C .r7 Amount Applied to Real Amount Remaining Excise Date of Excise Year Entitlement Estate for Excise Receipt # Receipt a44 4q, r4etIA (AU() r' u • �e"=k APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS :6;`-' 1i AND SURVIVING SPOUSES OF CERTAIN VETERANS (,. ) ' State Form 12662(R16/1-17) '' Prescribed by the Department of Local Government Finance INSTRUCTIONS: Please check appropriate box(es)pertaining to tax deduction.(More than one(1)box maybe checked;however,a surviving spouse who receives a deduction under Section Ill may not receive a deduction under Section IL) FILING DATES: REAL PROPERTY: FORM MUST BE COMPLETED AND SIGNED BY DECEMBER 31 AND FILED OR POSTMARKED BY THE FOLLOWING JANUARY 5. MOBILE HOMES(IC 6-1.1-7)OR MANUFACTURED HOMES NOTASSESSED AS REAL PROPERTY:DURING THE TWELVE(12)MONTHS BEFORE MARCH 31 OF EACH EAR FOR WHICH THE INDIVIDUAL WISHES TO OBTAIN THE DEDUCTION. FILE WITH THE C TY AUDITOR OF THE COUNTY WHERE THE PROPERTY IS LOCATED. I Totally disabled veteran(or veteran at least age 62 with at least 10%disability)or surviving spouse-Not to exceed$12,480 omplete sections I,V and VI. (IC 6-1.1-12-14) Partially service-connected disabled veteran or surviving spouse-Not to exceed$24,960 . Complete sections II,V and VI. (IC 6-1.1-12-13) ❑ III Surviving spouse of World War I Veteran-Not to exceed$18,720 Complete sections III,V,and VI. (IC 6-1,1-12-16) � ^ � Complete Sections IV,V,and VI. (IC 6-1.1-12-14.5) • APPLICANT Name of mplicant(first,middle,last) Address(numberand street,city,state,and ZIP code) County Applicant (❑ does ❑does not) own property with another individual(s)besides spouse and/or another veteran. This application is made for the purpose of obtaining$ deduction from the assessed valuation_of the following described taxable property for the year 202-0 . (If applicant desires that deduction be split among additional properties,list those properties on additional sheet and attach it to this application.) • Taxing District(city,town,township) th-property in question: Parcel or Key number 1 Pi Real Property ❑ Mobile Home(IC 6-1.1-7) -i2^15-10 0"©0( . 3 '-O 2 ..___.... ... . . .. . . ...... SECTION I - TOTAL DISABILITY OR AT-LEAST•AGE.62 WITH AT-LEAST.10%DISABILITY• - -- - - A. pplicant was a member of the U.S.Armed Forces for at least ninety(90)days(not necessarily during wartime). plicant was honorably discharged, r 25 , G 1 01-AR- IA Applicant is: yally disabled;or 1 �l1east age 62 with at least 10%disability (' ^3/1 4R-, D.❑ Applicant's disability is evidenced by: ❑Certificate of eligibility from the Indiana Department of Veterans Affairs; I❑ nsion certificate; A�ward of compensation from Veterans Administration or Department of Defense;or ❑Veterans Administration Form 20-5455"Tax Abatement Certificate" E,0 The assessed value of the applicant's Indiana real property,Indiana mobile home not a sedss real property,and Indiana manufactured home not assessed as real property does not exceed$175,000. Deductions claimed$ ? 6 _ . 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 sere' =.z ;t-cted disability of at least 10% D.❑ Applicant's disa•• ;s -N .- ced by: ❑ Certificate of eligibility from the Indiana Department of Veterans Affairs; \....\,,) �. ❑ Pension certificate; ❑Award of compensation from Veterans Administration or Department of Defense;or pp ti ttittst3�v 05 ❑ Veterans Administration Form 20-5455"Tax Abatement Certificate" , E.❑Applicant i g spo se• an individual who would have qualified for the deduction under this section when he or she was alive. (Age of dedL sed vetera r o.,ti-te of..,;;:'q ) ...:.2",.. . ..._ .... I . _,.... . . - _ - ..,SECTION III - SURVIVING SPOUSE OF A WORLD WAR I__ - _ . _ . - . . . A.❑ Applicant is t VV.: •, pouse of an individual who served in the U.S.Armed Forces before November 12,1918. B.❑ The seryieSo�fie deceased spouse is evidenced by: ❑ Letter from the Veterans Administration or the Department of Defense;or C� ❑ Honorable discharge documents C.❑ The deceased spouse received an honorable discharge, A person may not claim this deduction in conjunction with the partially disabled veteran deduction. ., __., ., ,.. -_.-._. . ... „ . .,..-_.. .SECTIONS IV,V,.AND VI ARE ON_REVERSE SIDE-. -. .... _. ., _ - Page 1 of 2 RECEIPT FOR APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERAN OR SURVIVING SPOUSE OF CERTAIN VETERANS i •J _ _ _ -SECTION IV;DEDUCTION.FOR HOMESTEAD DONATED TO VETERAN •• - _ 1. Applicant served in the military or naval forces of the United States for at least ninety(90)days; 2. Applicant received an honorable discharge; 3. Applicant has a disability of at least 50%; • 4. Applicant's disability is evidenced by: A. a pension certificate or an award of compensation issued by the United States Department of Veterans Affairs;or B. a certificate of eligibility 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 this new statue;and 5. Applicants 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 the individual 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. A veteran who claims this deduction for an assessment date may not also claim a partially disabled veteran deduction or totally disabled veteran deduction under IC 6-1.1-12-13 or 14,respectively,for that same assessment date. Moreover,an unused portion of this deduction may NOT be applied to excise taxes(See the Veteran Deduction Worksheet portion of this form.). ., -,:mr4 SECTION V.,tADDITIONAL INFOf2MATION 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 • (Note that a person applying for a deduction under Section IV must own the property.) 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 Li Taxing district _ _ •--_SECTION._V_I `c-APPLICATION_VERIFICATION,ANR.AUDITOR SIG,NATURE;,'. I certify that this application was filed in my office. I certify that the information provided in this application is true and Date filed( onth, Ar,year) • correct.The intentional inclusion of false information on this form is 2 O a criminal violation under IC 6-1.1-37-3 or4. signat coup audit r re of appli.- .r legal r esentative '14_ Name of county(�di or(typed or written) lin -111 - -- VETERAN.DEDUCTION WORKSHEET - - - 20 20 20 1. Total • ability($12,480) 2. Partial disability($24,960) • • 3. WWI surviving spouse($18,720)(Cannot be claimed in conjunction with the totally disabled veteran deduction.) 4. Homestead donated to veteran(Can be applied only to homestead applicant owns;cannot be claimed in conjunction with partial disability or total disability deductions.) 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).For motor vehicles,the unused portion of the veteran deduction reduces the annual excise tax in the amount of two dollars($2.00)on each one hundred dollars($100.00)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. However, unused portion of deduction for donated homestead may not be applied toward excise taxes. For more information,see IC 6-6-5-5 and IC 6-6-6.5-13. • Page 2 of 2:.- - - — -