State Form 12662 (R17 / 1-20)

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 II.)

FILING DATES:
FORM MUST BE COMPLETED AND SIGNED BY DECEMBER 31 AND FILED OR POSTMARKED BY THE FOLLOWING JANUARY 5 OF THE CALENDAR YEAR IN WHICH THE PROPERTY TAXES ARE FIR DUE AND PAYABLE.
FILE WITH THE COUNTY AUDITOR OF THE COUNTY WHERE THE PROPERTY IS LOCATED.

Name of applicant (Last, First MI)

Phone#:

Email:

Date of birth (mm-dd-yyyy)

Address

City

State

Zip Code

County

Applicant owns 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

A. (mark if applies)

B. (mark if applies)

C. Applicant is:(mark if applies)

D. Applicants disability is evidenced by: (Choose one, attach supporting documents)

E. (DO NOT ENTER)

Deductions claimed $

F. (fill if applicable)

(Age of deceased veteran on date of death

A. (mark if applies)

B. (mark if applies)

C. (mark if applies)

D. (Choose one, attach supporting documents)

E. (mark if applies)

(Age of deceased veteran on date of death

A

B

C

A person may not claim this deduction in conjunction with the partially disabled veteran deduction.

Name of applicant (Last, First MI)

Name of auditor

Parcel or Key number

Date (mm-dd-yyyy)

1. Applicant served in the military or naval forces of the United States for at least ninety (90) days;
2. Applicant received an honorable discharge;
3. Applicant has a disability of at least 50%;
4. Applicant’s disability is evidenced by:
A. a pension certificate or an award of compensation issued by the United States Department of Veterans Affairs; or
B. 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 this new statue; and
5. 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. (mark if applies)

 

Record number

 

page

(Note that a person applying for a deduction under Section IV must own the property.)

B. (mark if applies)

Amount $

County

Taxing district

Second county

Taxing district

I certify that the information provided in this application is true and correct. The intentional inclusion of false information on this form is a criminal violation under IC 6-1.1-37-3 or 4.

I certify that this application was filed in my office.

Date filed (mm-dd-yyyy)

Signature of county auditor

Click here to sign

Signature of applicant or legal representative

Click here to sign

Name of county auditor (typed or written)

20

20

20

1. Total disability ($14,000)

2. Partial (Service-Connected) disability ($24,960)

3. WWI surviving spouse ($18,720) (Cannot be claimed in conjunction with the totally disabled veteran deduction.)

 

5. Total deduction available (add lines 1, 2, 3, and 4)

6. Amount applied to real estate key number

7. Amount 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 deduction for donated homestead may not be applied toward excise taxes.
For more information, see IC 6-6-5-5 and IC 6-6-6.5-13.
See Special Instructions