Form 12662 - Application For Tax Deduction For Disabled Veterans, Wwi Veterans And Surviving Of Certain Veterans - 2013
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APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS,
WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
State Form 12662 (R13 / 8-13)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:
Please check appropriate box(es) pertaining to tax deduction. (More than one box may be checked; however, a surviving spouse who
receives a deduction under Section IV may not receive a deduction under Section II.)
FILING DATES:
REAL PROPERTY: DURING THE YEAR FOR WHICH THE DEDUCTION IS SOUGHT.
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.
I Totally disabled veteran (or veteran at least age 62 with at least 10% disability) or surviving spouse - Not to exceed $12,480
Complete sections I, V and VI. (IC 6-1.1-12-14)
II 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 World War I Veteran - Not to exceed $18,720
Complete sections III, V and VI. (IC 6-1.1-12-17.4)
IV Surviving spouse of World War I Veteran - Not to exceed $18,720
Complete sections IV, V, and VI. (IC 6-1.1-12-16)
APPLICANT
Name of applicant (first, middle, last)
Date of birth (month, day, year)
Address (number and 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 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, township)
Is the property in question:
Parcel or Key number
Real Property
Mobile Home (IC 6-1.1-7)
SECTION I - Total Disability OR at least age 62 with at least 10% disability
A.
Applicant was a member of the U.S. Armed Forces for at least 90 days (not necessarily during war time).
B.
Applicant was honorably discharged.
C.
Applicant is:
Totally disabled; or
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;
Pension certificate;
Award of compensation from Veterans Administration or Department of Defense; or
Veterans Administration Form 20-5455 “Tax Abatement Certificate”
E.
The assessed value of all of the tangible property the applicant owns does not exceed $143,160. Deductions 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.
(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 service connected disability of at least 10%
D.
Applicant’s disability is evidenced by:
Certificate of eligibility from the Indiana Department of Veterans Affairs;
Pension certificate;
Award of compensation from Veterans Administration or Department of Defense; or
Veterans Administration Form 20-5455 “Tax Abatement Certificate”
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___________________)
SECTION III - World War I Veteran
A.
Applicant is a veteran of World War I.
B.
Applicant’s service is evidenced by:
Letter from Veterans Administration or Department of Defense; or
Discharge documents
C.
The assessed valuation of the property for which the deduction is claimed (may not exceed $206,500) $__________________________________
D.
The property is the applicant’s principal residence.
E.
The applicant owned the property (or was buying it under contract) for at least one year before the date of this application.
SECTIONS IV, V, AND VI ARE ON REVERSE SIDE
RECEIPT FOR APPLICATION FOR TAX DEDUCTION
FOR DISABLED VETERAN, WWI VETERAN OR SURVIVING SPOUSE OF CERTAIN VETERANS
I certify that the applicant filed on this date an application for the following deductions described on State Form 12662:
SECTION I
SECTION II
SECTION III
SECTION IV
Name of applicant (first, middle, last)
Name of auditor
Parcel or Key number
Date (month, day, year)
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