HomeMy WebLinkAboutVeterans_Vinnedge .ct - _ �1, APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS
,1 tin AND SURVIVING SPOUSES OF CERTAIN VETERANS
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/ State Form 12662(R19/7-25)
Prescnbed by the Department of Local Government Finance
INSTRUCTIONS: Please check appropriate box(es)pertaining to the applicable tax deduction. (More than one(1)box c
Individual who claims a deduction under Section III may not claim a deduction under Section I or Section I1 for that same assessment
date. (IC 6-1.1-12-14.5))
FILING DATES:
This form must be completed, signed. and filed by January 15 of the calendar year in which the property taxes are first due and paPieile2ort3 th242r5y
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 $14,000 /1 V
Complete Sections 1, IV. and V. (IC 6-1 1-12-14) (., L - _ , /��
❑II Veteran with Service-Connected Disability or Surviving Spouse-Not to exceed$24,960 /L.ZaZ4L/ &. .YYQ.th- rid)
Complete Sections 11, IV, and V. (IC 6-1.1-12-13) GIBSON COUNTY AUDITOR
❑III Deduction for Homestead Donated to Veteran
Complete Sections Iii, IV, and V. (IC 6-1.1-12-14.5)
APPLICANT
Name of Applicant(first,middle, last) }
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I R 3(5 1- II 5 o S (, l<-,
Applicant°does/❑does not)own property with another individual(s)besides spouse and/or another veteran.
This application is made for the purpose of obtaining$ deduction from the assessed valuation of the following described taxable
property for the year 20 ,. (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. townships) Is the property in question Parcel or Key Number
y, l) `f ,.\\P;` G-- Real Property ❑Mobile Home (IC 6-1.1-7) '26_/tJ_ - 3CCr COI, ,i ,- 0 c
SECTION I TOTALLY DISABLED VETERAN OR VETERAN AT LEAST AGE 62 WITH DISABILITY OF 10%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: ❑Has a total disability, or
Ells 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("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.❑The assessed value of the applicant's Indiana real property, Indiana mobile home not assessed as real property, and Indiana manufactured home not
assessed as real property does not exceed $240,000. Deductions claimed $
F.❑Applicant is the surviving spouse of an individual who. (1)would have qualified for the deduction 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 II VETERAN WITH SERVICE CONNECTED DISABILITY
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 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-
12-13;
❑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
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 )
SECTIONS III,IV, and V ARE ON REVERSE SIDE.
Page 1 of 2
RECEIPT FOR APPLICATION FOR TAX DEDUCTION
FOR DISABLED VETERAN OR SURVIVING SPOUSE OF CERTAIN VETERANS
I certify that the applicant filed on this date an application for the following deduction(s) described on State Form 12662:
❑SECTION I ❑SECTION II ❑SECTION III
Name of pra,77,t middle.lest) Name of Auditor
2 Z/j-2--'•-:
- •••••..9.
Number
Parcel or Key "�� Date(month. day.
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SECTION III 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.0 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 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 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 the Veteran with Service-Connected Disability Deduction or the
Totally Disabled Veteran or Veteran at Least 62 with Disability of 10%or More 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 IV 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 (Note that a person applying for a deduction under Section IV must own the properly.)
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 V APPLICATION VERIFICATION AND AUDITOR SIGNATURE
I certify that this application was filed in my office.
I certify that the information provided in this application is true and Date Fi (month, day, year
correct. The intentional Inclusion of false information on this form is a — 4Q I
cnminal violation under IC 6-1.1-37-3 or 4. Signature of County Auditor
Ltr-1---- LO___.1.-1-.. Ct-9.--Qa 8-' L0a3- V-A:rt-Zirs...0
Signature of Applicant or Legal Represent ve Name of County Auditor(typed or written) ,.
-I 1 CIL, j. Ot\ VP % ii 60 tik • ak % _ft 411 AI
VETERAN DEDUCTION WORKSHEET
20 20 20
1. Totally Disabled Veteran or Veteran at Least 62 with Disability of 10%
or More ($14,000)
.
2. Veteran with Service-Connected Disability($24,960)
3. Homestead Donated to Veteran(Can be applied only to owner of the
homestead; cannot be claimed in conjunction with deduction under IC
6-1.1-12-13 or IC 6-1.1-12-14.)
4. Total Deduction Available(add lines 1, 2, and 3)
5. Amount Applied to Real Estate Key Number
6. Amount Applied to Personal Property Duplicate Number
7. Amount Applied to Mobile Home Duplicate Number
8. Total Deduction Applied to Taxable Property(Add Lines 5, 6, and 7)
9. Deduction Available for Excise` (Subtract Line 8 from Line 4)
10. 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 Homestead Donated to Veteran Deduction may riot 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
Tax deduction amount z • tl i; •
For County Auditor Use Only -
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VA Benefit Details .
SERVICE-CONNECTED DISABILITY: A condition incurred during or aggravated by military service,
for which the Veteran is receiving VA benefits.
COMBINED SERVICE-CONNEC VI EVALUATION: The Veteran's disability rating for all conditions
determined to be service-connected.
CURRENT MONTHLY AWARD AMOUNT: The monthly monetary benefit paid to the Veteran or
survivor receiving benefits under a VA program.
NON-SERVICE-CONNECTED PENSION: Benefit for a non-service connected Veteran who meets
specific criteria, which include disability or age, wartime service, minimum length of service, and income
restrictions. If a Veteran is eligible for service-connected benefits and pension benefits, VA will pay the
higher benefit.
INDIVIDUAL UNEMPLOYABILITY (IUD: The Veteran is receiving payment at the 100 percent rate,
even though the combined service-connected evaluation is not 100 percent. The Veteran's service-
_ _ connected conditions cause him/her to be unable to_obtain or maintain substantially gainful employment _ _ _ _ _
because of the Veteran's service-connected conditions. The Veteran must periodically certify continued
• unemployability, but if there is no scheduled future reduction or medical examination required, he/she may
be considered by some states to be permanently and totally disabled.
PERMANENT AND TOTAL (P&T) DISABILITY: The Veteran is considered by VA to be permanently
and totally disabled because of his/her service-connected conditions.
SPECIAL MONTHLY COMPENSATION: The Veteran is receiving additional compensation for one
or more of the following: a service-connected loss of or loss of use of one or more specific organs or
extremities; a combination of severe disabilities; is 100 percent disabled and housebound, bedridden, or
in the need of the aid and attendance of another person.
SPECIALLY ADAPTED HOUSING and/or SPECIAL HOME ADAPTATION GRANT: Grants provided
by VA to service-connected veterans and service members to help build a new specially adapted house,
to adapt a home they already own, or buy a house and modify it to meet their disability-related
requirements.
Wartime Service Periods
Mexican Border Period: May 9,, 1916, through April 5, 1917, for veterans who served in Mexico, on
its borders or in adjacent waters.
World War I: April 6, 1917, through Nov. 11, 1918; for veterans who served in Russia, April 6, 1917,
thoough April 1, 1920; extended through July 1, 1921, for veterans Who had at least due day bf service-
between April 6, 1917, and Nov. 11, 1918.
World War II: Dec. 7, 1941, through Dec. 31, 1946.
Korean War: June 27, 1950, through Jan. 31, 1955.
Vietnam War: Aug. 5, 1964 (Feb. 28, 1961, for veterans who served "in country" before Aug. 5, 1964),
through May 7, 1975.
•
`For Pension- Aug. 5, 1964 (Nov. 1, 1955, for veterans who served "in country" before Aug. 5, 1964),
through May 7, 1975.
Gulf War: Aug. 2, 1990, through a date to be set by law or Presidential Proclamation.
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