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Home My WebLink AboutVeterans_Bartholomew 7 .:ikli APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS �' ' % Siete Farm 12562(R 19 r 7.25j Presutbed by the Department a Lop!Government Finance INSTRUCTIONS: Please check appropriate box(es)pertaining to the tipper able lax deduction (More then one(1)box may be choked;however, an individual who claims a deduction under Section 111 Inay not claim a c$edorction under Section for Section 11 for that same assessment date. (IC 6-1.1-12-14.5)) F!LING OATES. This form must be completed,signed.end feed by January 15 of the calendar year in which the property taxes are first due and payable.File with the county auditor of the county where the poverty is located- 0 I Totally Disabled Veteran(or veteran at least age 62 with at least 10%disability)or Surviving Spouse-Not to exceed S14,000 Complete Sections i, IV, and V. (IC 6-1.1-12-14) ❑II Veteran with Service-Connected Disability or Surviving Spouse-Not to exceed S24, l\r- i cr Applicant Kies lDdoes not)own property with another indrvidual(s)besides spouse and/or another veteran.(.__ - This application is made for the purpose of obtaining S - deduction from the assessed valuation of the following (Or tT►e 20 described taxable property year .(If applicant desires that deduction be split among additional properties, list those properties on additional sheet and attach it to(his application.) Taxing District{city-.town. awnstnrps) � la the a -- - - , property in questirin Parcel or Key Number •. b� �fteal Property ❑AAoD+Ie Horne(IC 6 1.1-7) O. - (L - tg - L 1 ,e . .. 001 • Lot ' SECTION I TOTALL 'DISABLED VETERAN OR VETERAN AT LEAST AGE 62 WITH DISABILITY OF I0 OR MORE tj A. !1 Applicant served in the military or naval forces of the United States for at least nine 90 B.[a 'pplicant was honorably discharged. ninety( )dev days(not necessanly during war frmo). C./(Applicant MHas a total disability; or Ells at least age 62 with . 10%disability D.❑Applicants disability is evidenced by: Certificate of eligibility from the Indiana Department of Veterans Affairs(-OVA")after IDVA has determined that the individual's disability qualifies the indnndual to receive a deduction under It: 6-1.1- 12-14, Pension certificate fron the U.S. Deportment of Veterans Affairs;or Award of compensation from U.S. Department of Veterans Affairs E.❑The assessed valve of the applicant's Indiana real property, Indiana mobile home not assessed as real property.and Indiana manufactured hone not assessed�� as real property does not exceed S240,000. Deductions claimed S • � � F. vl is the surviving spouse of an individual who:(1)vexed have qua ifsid for the deduction under this section when he or she was alive:or(2)was killed in action.died white scxvfrtg on active duty,or died while performing inactive duty training.(Age oul desvased veteran on dare of death J SECTION II VETERAN WITH SERVICE CONNECTED DISABILITY A.DAppacant served in the military or naval forces of the United States during any of es wars. B.DApplicant was h nom-abty discharged. C.D Applicard has a service-connected disability of al least 10%or more. o.0 Applicant's disability is evidenced ed by: 0 Certificate of eligibility from the Indiana Department of Veterans Affairs(-OVA-)after IDVA has determined that the Individuals 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.QApplicarll is the surviving spouse of on 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 ) SEC(rDr1S fft 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 'Flame of Applicant Vim mediate less3 of Auditor Pan*or Kay Number Date(mom.dry.veer) 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 1901 days. 8. _ Applicant was honorably discharged. C. Applicant has a d aehility of at least 50%. D_DApplicants 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(•1DVA') after IDVA hes determined that the eldtviduare disability qualifies the Individual to receive a deduction under IC t'-1.1.12-14.5 E.DApplicant'a homestead was conveyed**how charge to the applicant who is the owner of the homestead by an organization that is exempt from irxxxne taxation under the federal Internal Revenue Code. The amount of the deduction is determined as follows: 1.If the applicant is totaly 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 des.a�7ity of at least 60%but less than 70%,the deduction is equal to 60%of the assessed value of the homestead 6.1f the applicant has a disability of at least 50%but less than 60%.the deduction rs equal to 50%of the assessed value of the homestead. A veteran who claims this deduction for an assessment data may not also claim the Veteran with Service-Connected DisaWltty Deduction or the Totally Olsabted Veteran or Veteran at Least 62 with Disability of 10%or More Deduction under IC 6-1.1-12-13 or 14,respecttvly, for that saute assessment data.Moreover,an unused portion of M.deduction may NOT be applied to excise taxes(Sae the Moran Deduction Worksheet portion of MI'form). SET,TION IV ADDITIONAL INFORfr1ATION A.DApplicant owns the property on wnict,the deduction is claimed or is burying II under rnntract that provides that the applicant is to pay the properly taxes,which contract.or a memorandum of the contract. is recorded in the County Recorder's office. Record Number Page (Note that a parser applying fora deduction under Section IV must rim the property_) a.QApplicant has applied or intends to apply for one or more of these deductions on other property in this county or In another county. Dyes No Amount S County - taxing District Seoonti County Taxing(?ietrtc! - - - - SECTION V APPLICATION VERIrICATsort AND AUDITOR SIGNATURE I certify that this application was tried In my office. I certify that the Information provided In this application Is true and Data Fled(month,day,yam correct.The intentional inclusion of false information on this form Is a ,°Li- criminel violation under EC 8-1.1-37-3 or 4. Synatuts or cram*AuditorAuditor... has ..p - _ � ( . j ram . `�o!L K.r Nam,,r Counts,Auditor(typed e,»„d,ra„) ` � r. —0-. Q I • U3 C R VETERAN DEDUCTION 1!I'ORKSHEET 20 20 20 1. Totally Disabled Veteran or Veteran at Least 62 rath Disability of 10% or Mote($14,000) 2. Veteran with Service-Connected Cambay(S24,060) 3. Homestead Donated to Veteran (Gan be applied only to owner of fie homestead,cervioi be claimed in con/um-lion with deduction under IC 6-1.1-12-13or$C 6-1.1-12-14.) 4, Total Deduction Avalgble(add does 1, 2,end 3) 5. Amount Applied to Reel Estate Key Number_ - r 6. Amount Applied to Personal Property Dupilcate Number - 7. Arnuunt Applied to Mobile Home Duplicate Number 8. Total Deduction Applied to Taxable Property(Add Lines 5, 0, end 7) 9. Deduction Avalabie 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 5-6-5.5)or Aircraft License Excise Tax(IC 6-6 6.5113). For motor vehicles,the unused portion of the veteran deduction reduces the annual excise tax in the amount of two dollars(S2.00)on eedr one hundred dollars(S 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 0.0T. However, unused portion of Homestead Donated to Veteran Deduction may not b.r applied toward excise taxers. For more Information,see IC 6- 6-5-5 and IC 8-6-6.5.13. Page 2 of 2 ,,A.51 E:4 DEPARTMENT OF VETERANS AFFAIRS /4 Y'\A\ CERTIFICATE OF ELIGIBILITY 777 North Meridian Street, Suite 300 s ' DISABLED VETERAN TAX DEDUCTION polls, Indiana 46204-1421 Indiana .. __ �! State Form 51186 (R6 / 7-20) Telephone: (317) 232-3910 "'` ' Fax: (317) 232-7721 * In determining 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. Tax d lion a o t (1) For County Auditor Use Only i 1 .' ,;� An1 \ 5 t ♦ F L • A 1 r . I ' t , 4 f r t 2e1dba6c-d155-43df-b650-eb76e0d31ee2