Veterans_Wilkison (2) Form Number 12A - Revised 1977 CQ/ — ,4-)//d / t ro .& 1 n�"'
y �+ ,s
Pre•scribed by State Board of Tax Commisrr egr.' s0//�� 1 a ~S ron
o V�• �\ )D-a)-O'f
VETERANS, OR THEIR WIDOWS, STATEMENT OF SERVICE-CONNECTED DISABILITY
and Application for Deduction From the � •
P P !_
II Assessed Valuation of Taxable Property .
*** Qualifications On Back * **
STATE OF INDIANA COUNTY ,
-0(Name ) OS . 7/0_,? I�.C.GI.�l�� being duly sworn on oath says
that (s)he is 3 "years of age ; that (s res Fr/4
OL
UX- /g Couh Indiana ; that (s )he
Check One : was a Member of the U . S . Armed Forces during any of
its wars
or the widow of a member of the U . S . Armed Forces
who served during any of its wars
and who has been honorably discharged therefrom and has a service-
connected disability of ten percent (10 percent) or more and is
entitled to this deduction as evidenced by :
Pension Certificate or
Award of Compensation or
Veterans Administration Form 20-5455 "Tax Abatement Certificate" or
Letter statement of ten percent disability or more from the
r" Department of the Defense Disability Retirement Board of the
appropriate branch of the armed forces
1
exhibited to the County Auditor.
tdr
• IC 6-1. 1-12-13 and 6-1. 1-12-15 //ac
=•
That this application is made for the purpose of obtain T. :�'L
(not to exceed two thousand -dollars) deduction from the assessed valu-
ation of the following described taxable property for the year 19 r0"17�
_
to wit : /�
TAXING DISTRICT ALAT-X_.-- -4-
::! _t, . , - .
LEGAL DESCRIPTION OR KEY NUMBER 4 — dr .
e-6---g
That , i ,-_ a- to the above amount of $ deduction applied
for i -h� , (s ) he has or intends to apply for $ deduction
in 1AR & 198Z County , Taxing District .
*°Uo11°R qCjIllj)e . •X 4D ely:..j. Si AZ .
(Applicant/Guardian
ie. Subscribed and sworn to before me , and disability verified this '15 7
-77?day of ( /'LG/L- , 19 O l— .
Auditor -
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Rea r e wl in enance-Wilkison,Daniel L/Ann EfRick-y B,MTh E BOO S,BUCKSKIN IN 4iE? — 0
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• Real type 1'eal _II Property Property 126 20-27-100-001.150-001 1•
�Identifi'ation I Fr Address VValuations I Taxes_I FrTransfers I Fr Specials I VNotes I Adjustments I Lender I E BillingI FrHistory I
Current ''ssessments
_ —Typ= _ Current Value Certified Value 1 Eligible Value ;Reason( Homestead(1%) 0
Home __--- Re 42700
Horn:stead Improv 0 . 0 30700 Miscellar — C,Ag(2 0)
New s LT
. , Non- omestead Land 12000 12000 0 Miscellar
_. Non Res(3%) 3000
Non- omestead Impr 30700 30700 0 Miscellar; -__ _-r__ -
Corn ercial Apt Land 0 0 ' 0 Miscellar Modify
Corn_ ercial Apt Improv 0 ' 0 0 Miscellar
1
Total Land 15000
Long erm Care Land 0 0 t 0 Miscellar
Long erm Care Improv 0 0 0 •Miscellari
9 Total Improvement 30700
Agric Rural Land 0 ' 0 , 0 Miscellar;
•
Mobil Home Land 0 0 0 Miscellari Total Assessed 45700
/ Nonre-idential Land 3000 3000 3000 Miscellar]
( Nonre-idential Improv 0 0 ' 0 Miscellar Net Assessed 44710
—Cu _ ■ •ductions
Type ; Current Value , Certified Value Override escnptlon - New
r Homestead Approved'
'Veteran _.tal* 990 990 Yes ,_____.___ IT Over 65 C.B.
Remove I r Under Appeal.
_ s -}, ModifyI
r
r Homestead Verification
r Multi Use
Type ' Current'value ' Certified Value
NetAsses-ed Value 44710 44710 j
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