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APPLICATION FOR DEDUCTION FROM ASSESSED VALUATION 20____ PAY 20____
REAL PROPERTY VACANT BUILDING DEDUCTION
State Form 53179 (R5 / 1-21) FORM 322 / VBD
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:
1. This form is to be filed with the county auditor of the county in which the eligible vacant building is located.
2. To obtain a vacant building deduction, a Form 322/VBD must be filed with the county auditor before May 10 in the year in which the property owner or
his tenant occupies the vacant building or not later than thirty (30) days after the assessment notice is mailed to the property owner if it was mailed after
April 9. If the property owner misses these deadlines in the initial year of occupation, he can apply between January 1 and May 10 of a subsequent year.
3. The eligible vacant building must have been unoccupied for at least one (1) year and be zoned for commercial or industrial purposes.
4. A copy of the approved Form SB-1/VBD, the resolution adopted by the designating body, and the Form CF-1/VBD must be attached to this application.
5. A property owner who files this form must provide the county auditor and the designating body with a Form CF-1/VBD to show compliance with the
approved Form SB-1/VBD. The Form CF-1/VBD must also be updated and provided to the county auditor and the designating body for each
assessment year in which the deduction is applicable.
SECTION 1 PROPERTY INFORMATION
Address of property (number and street, city, state, and ZIP code)
County Township DLGF taxing district number Parcel number
Name of owner Name of contact person
Mailing address of owner (number and street, city, state, and ZIP code)
Telephone number Fax number E-mail address
( ) ( )
SECTION 2 REQUEST FOR DEDUCTION AND DESCRIPTION OF BENEFIT TO TAXING JURISDICTION
Describe the real property investment
Total cost of the real property investment
Is this property within an Economic Revitalization Area (ERA)? Is this property within a Tax Increment Financing (TIF) district as defined in IC 6-1.1-21.2-3?
Yes No Yes No
ASSESSED VALUE OF LAND ASSESSED VALUE OF ASSESSED VALUE OF LAND AND *ASSESSED VALUE OF ELIGIBLE
IMPROVEMENTS IMPROVEMENTS (TOTAL A/V) VACANT BUILDING
$$$ $
*NOTE: The amount of the deduction is the assessed value of the building or part of the building that is occupied by the property owner or a tenant of the
property owner that qualifies as an eligible vacant building as defined in IC 6-1.1-12.1, multiplied by the percentage determined by the designating body
under IC 6-1.1-12.1-17.
I hereby certify that the above named taxpayer is liable for property taxes at the above listed location on the indicated assessment date and that the
representations on this application are true and correct. I further certify that the real property investment identified above is eligible for the vacant
building deduction as outlined in IC 6-1.1-12.1-4.8 and IC 6-1.1-12.1-16, as applicable.
Signature of owner or representative (if representative, attach power of attorney) Date signed (month, day, year)
Printed name of signatory Title Telephone number of preparer
( )
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