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HomeMy WebLinkAboutVeterans_Williamson'N� APPLICATION FOR PROPERTY TAX BENEFITS FOR DISABLED VETERANS 4 AND SURVIVING SPOUSES OF CERTAIN VETERANS State Form 12662 (R20 / 6-26) Prescribed by the Department of Local Government Finance Instructions: Please check appropriate box(es) pertaining to the applicable tax deduction or credit. More than one (1) box may be checked; however, an individual who claims a deduction under Section 1 may not claim a credit under Section 11 or Section 111 or a deduction under Section V for that same assessment date. (IC 6-1.1-12-14(d); IC 6-1.1-12-14.5(d)) --ding Date: This form must be completed, signed, and filed by January 15 of the calendar year in which the property taxes are first due and payable. File with t county auditor of the county where the property is located. I Totally Disabled Veteran or Surviving Spouse — Deduction of 100% of the assessed value of principal place of residence Complete Sections 1, VI, and Vll. (IC 6-1.1-12-14) ❑ II Veteran with Service -Connected Disability or Surviving Spouse — Credit not to exceed $350 Complete Sections ll, Vl, and VII. (IC 6-1.1-51.3-6) ❑ III Veteran at least Age 62 with at least 10% Disability or Surviving Spouse — Credit not to exceed $250 Complete Sections lll, Vl, and VII. (IC 6-1.1-51.3-5) ❑ IV Surviving Spouse of World War I Veteran — Deduction not to exceed $18,720 Complete Sections IV, Vl, and Vll. (IC 6-1.1-12-16) ❑ V Deduction for Homestead Donated to Veteran Complete Sections V, Vl, and VII. (IC 6-1.1-12-14.5) APPLICANT INFORMATION Name of Applicant (first, middle, last) Date of Birth (month, day, year) Telephone Number Williamson, Pete J 1- Address (number and street, city, state, and ZIP code) County Email Address 304 N Main St Ft Branch, IN 47648 Gibson 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 and/or $ credit against local property taxes imposed on the following described taxable property for the year 20 (If applicant desires that a credit be split among additional properties, list those properties on additional sheet and attach it to this application. The deductions under Section I and Section V may only apply to the applicant's homestead property.) Taxing District (city, town, townships) I Is the property in question: Parcel or Key Number A Branch I ® Real Property ❑ Mobile Home (IC 6-1.1-7) 126-18-13-402-000.674-026 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. D. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility (Section VIII) 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. ❑ Applicant has resided in Indiana for at least one (1) year before the assessment date for which this deduction is claimed. 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 and the applicant has not subsequently remarried. G. ❑ Applicant uses the property on which the deduction is claimed as the applicant's homestead (principal place of residence). A veteran who claims this deduction for an assessment date may not also claim the Homestead Donated to Veteran Deduction under IC 6-1.1-12- 14.5 or receive a local property tax credit under IC 6-1.1-51.3 for that same assessment date. 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 (Section VIII) from the Indiana Department of Veterans Affairs ("IDVA") after IDVA has determined that the individual's disability qualifies the individual to receive a credit under IC 6-1.1- 51.3-6; ❑ 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 ❑ Applicant is the surviving spouse of an individual who would have qualified for the credit under this section when he or she was alive. Page 1 of 2 Q� •--------------------------------------------------------------------\.j A11111 • . • •- 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 is at least age 62 with at least 10% disability. J D. ❑ Applicant's disability is evidenced by: ❑ Certificate of eligibility (Section VIII) 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. ❑ Applicant is the surviving spouse of an individual who: (1) would have qualified for the credit 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- 3MIM•• • •- A. ElApplicant is the surviving spouse of an individual who served in the military or naval forces of the United States before November 12, 1918. B. ❑ The service of the deceased spouse is evidence by: ❑ Letter from the U.S. Department of Veterans Affairs; or El Honorable discharge documents C. ElThe deceased spouse received an honorable discharge. 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. ❑ 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 (Section VIII) 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 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. `veteran who claims this deduction for an assessment date may not also claim the Totally Disabled Veteran Deduction under IC 6-1.1-12-14 for it same assessment date. Moreover, an unused portion of this deduction may NOT be applied to excise taxes. • �•- [ORIIIIIIN A. ❑ Applicant owns the property on which the deduction or credit 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 V must own the property.) B. ❑ Applicant has applied or intends to apply for one or more of these credits on. other property in this county or in another county. ❑ Yes ❑ No Amount $ County Taxing District Second County Taxing District •0 Lai• •- I certify that this application was filed in my office. I certify that the information provided in this application is true and Date Filed (month, day, year) correct. The intentional inclusion of false information on this form is a I-f,:�1-0ZI criminal violation under IC 6-1.1-37-3 or -4. Signature of County AAuu�dito'r�//�- L t 1/ �� C.fi. yY�L2i`retiYtN/� Sigq.atur of pl t or gal Representative Name of County Auditor (typed or written) Michael A Watkins PIEFINI Veterdn's Military Service 'character of discharge E? More than ninety (90) days =onorable or Under Honorable Conditions _LeteraWb type of service (check one) VA disability rating Veteran's date of birth (month, day, year) Wartime service ❑ Peacetime service (� (r11 ? ,� Accredited IDVA staff or ccred' ` I a unt teran Service Offi signature Date (month,dray, year) �' 66 Page 2 of 2 Reset Form aunt x APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS +Sic AND SURVIVING SPOUSES OF CERTAIN VETERANS FILED ram o_-! State Form 12682(RIB!9-24) Prescribed by the Department of Local Government Finance INSTRUCTIONS: Please check appropriate box(es)pertaining to tax deduction.(More than one(1)box may be checked;however,a surviving spouse who receives a deduction under Section III may not receive a deduction under Section IL) FILING DATES: ` L9 2i 2t5 Formorm c must be completed,signed,and filed by January 15 of the calendar year In which the property taxes are first due and pay a Ih he 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 mplete Sections I,V and VI. (IC 6-1.1-12-14) I Veteran with Service-Connected Disability or Surviving Spouse—Not to exceed$24,960 Maid a Complete Sections II,V end VI. (IC 6-1.1-12-13) Address(number and sheet,city,slate,and ZIP code) 1 l-11A t.lounty ©� . &� � t1 •t. �t . r�nc_a� � '�.tb r) Applicant( oes 0 does not)own property with anol,er individual(s)besides spouse and/or another veteran. This application is made for the purpose of obtaining$ p!t-{tq OCTH 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 roperty In question: Parcel or Key Number C,r '� eal Property 83 Mobile Home(IC 6-1.1-7) DID—' Is,- - -Oc SECTION I—TOTALLY DISABLED VETERAN OR VETERAN AT LEAST AGE 62 WITH DISABILITY OF 10%OR MORE A.0 Applicant served In the military or naval forces of the United States for at least ninety(90)days(not necessarily during war time). B.0 Applicant was honorably discharged. C.0 Applicant: 0 Has a total disability;or ❑Is at least age 62 with at least 10%disability D.0 Applicant's disability is evidenced by: ❑Certificate of eligibility from the Indiana Department of Veterans Affairs('lDVA')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.0 The assessed value of the applicant's Indiana real property,Indiana mobile home not assessed as real property,and In ' ma fa red ho assessed as real property does not exceed$240,000.Deductions claimed$ 12) 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;o killed in action,died while serving on active duty,or died while performing inactive duty training.(Age of deceased veteran on -of death SECTION II—VETERAN WITH SERVICE-CONNECTED DISABILITY A. L!AyLplicant served in the military or naval forces of the United States during any of Its wars. 025 B. IVA:plicant was honorably discharged. C.pirAEOicant has a service-connected disability of at lea t 10%or more. D. pplicant's disability Is evidenced by: ertiffcate of eligibility from the Indiana Department of Veterarig DVA h determined that the individual's disability qualifies the individual to di u�dA/IC 6-1,1- 12-13; tine 7 • ❑Pension certificate from the U.S.Department of Veterans Affairs;or r 7q * ❑Award of compensation or disability compensation check from U.S.Department of Veterans ati®R 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 dale of death SECTION III—SURVIVING SPOUSE OF A WORLD WAR I VETERAN A.0 Applicant is the surviving spouse of an individual who served In the military or naval forces of the United States before November 12,1918. B.0 The service of the deceased spouse is evidence by: 0 Letter from the U.S.Department of Veterans Affairs;or 0 Honorable discharge documents C.0 The deceased spouse received an honorable discharge. A person may not claim this deduction in conjunction with the partially disabled veteran deduction provided by IC 6-1.1-12-13. 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 certify that the applicant filed on this date an application for the following deduction described on State Form 12662: ❑SECTION I EkSICTION II ❑SECTION III ❑SECTION IV I �\Name of Applicant(first,middle,Iasi) Name of Auditor Parcel or Key Number Date(month,day,year) -Lk0�-ts00. .101`-)\- O o SECTION IV-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. 0 Applicant was honorably discharged. C.❑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 0 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(he applicant haa`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 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 (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. 0 Yes 0 No Amount$ County Taxing District Second County Taxing District • SECTION VI-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 Flied(month,day,year) correct.The intentional inclusion of false information on this form is a criminal violation under IC 6-1.1-37-3 or 4. signature of Countytauditor I J Sigpire of titan,. egal Representative Name of Con uditor(typed or ntlen Lo VETERAN DEDUCTION WORKSHEET '*``, 20 20 20 t1. Totally Disabled Veteran or Veteran at Least 62 with Disability of 10% .'-oi.More($14;000) 2.-"Veteran with Service-Connected Disability($24,960) 3. Surviving Spouse of WWI Veteran($18,720)(Cannot be claimed in conjunction yvith.deduction under IC 6-1.1-12-13.) 4.-'Homestead Donated to Veteran(Can be applied only to owner of the homestead;cannot be claimedin conjunction with deduction under 1C 6-1.1-12-13 or 1C 6-1.1;12-14.), 5. Total Deduction Available;(add dries 1,2,3,and 4) 6. Amount Applied`to Real Estate Key Number • Amotint 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 Homestead Donated to Veteran Deduction may not be applied toward excise taxes,and the unused portion of Surviving Spouse of WWI Veteran Deduction may not be applied toward Aircraft License Excise Tax.For more information,see IC 6-6-5-5 and IC 6-6-6.5-13, Page 2 of 2 Tax u u tion For Count��0ux������� ��l� ^� K` / / \ ~ ^ �--� —|��\~� l � �~ ` �--_--~~--� ~. \^ / / \_ \