Reset Form

           STATEMENT OF BENEFITS                                                                                                              20____ PAY 20____
           VACANT BUILDING DEDUCTION
           State Form 55182 (R2 / 1-21)                                                                                                       FORM SB-1 / VBD
           Prescribed by the Department of Local Government Finance
                                                                                                                                              PRIVACY NOTICE
This statement is being completed for real property that qualifies as an “eligible vacant building” as defined by                             The cost and any specific individual’s 
IC 6-1.1-12.1-1(17).                                                                                                                          salary information is confidential; the 
                                                                                                                                              balance of the filing is public record 
                                                                                                                                              per IC 6-1.1-12.1-5.1 (c) and (d).
INSTRUCTIONS:
1. This statement must be submitted to the body designating the Economic Revitalization Area prior to the public hearing if the designating body 
   requires information from the applicant in making its decision about whether to designate an Economic Revitalization Area.  Otherwise, this statement 
   must be submitted to the designating body BEFORE the occupation of the eligible vacant building for which the person wishes to claim a deduction.
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 10.  If the property owner misses the May 10 deadline in the initial year of occupation, he can apply between January 1 and May 10 
   of a subsequent year.
3. A property owner who files the Form 322/VBD 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 each year in which the deduction is applicable.

   SECTION 1                                                      TAXPAYER INFORMATION
Name of taxpayer

Address of taxpayer (number and street, city, state, and ZIP code)

Name of contact person                                                                Telephone number                      E-mail address
                                                                                      (            )
   SECTION 2                              LOCATION AND DESCRIPTION OF PROPOSED PROJECT
Name of designating body                                                                                                    Resolution number

Location of property                                                                  County                                DLGF taxing district number

Description of eligible vacant building that the property owner or tenant will occupy (use additional sheets if necessary). Estimated occupancy date (month, day, year)

                                                                                                                            Estimated date placed-in-use (month, day, year)

   SECTION 3             ESTIMATE OF EMPLOYEES AND SALARIES AS A RESULT OF PROPOSED PROJECT
Current Number           Salaries              Number Retained                        Salaries                              Number Additional Salaries

   SECTION                                ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT
                                                                                                    REAL ESTATE IMPROVEMENTS
                                                                                      COST                                  ASSESSED VALUE
Current values
Plus estimated values of proposed project
Less values of any property being replaced
Net estimated values upon completion of project
   SECTION 5                                   EFFORTS TO SELL OR LEASE VACANT BUILDING
Described efforts by the owner or previous owner to sell, lease, or rent the building during period of vacancy:

Show amount for which the building was offered for sale, lease, or rent during period of vacancy.

List any other benefits resulting from the occupancy of the eligible vacant building.

   SECTION 6                                                      TAXPAYER CERTIFICATION
                                          I hereby certify that the representations in this statement are true.
Signature of authorized representative                                                Title                                 Date signed (month, day, year)

                                                                                      Page 1 of 2

                                                          FOR USE OF THE DESIGNATING BODY
We find that the applicant meets the general standards in the resolution adopted or to be adopted by this body.  Said resolution, passed or to be passed 
under IC 6-1.1-12.1, provides for the following limitations:
    A.  The designated area has been limited to a period of time not to exceed ____________ calendar years* (see below).  The date this designation 
         expires is _____________________.  NOTE: This question addresses whether the resolution contains an expiration date for the designated area.
    B.  The amount of the deduction applicable is limited to $ ___________________.
    C.  Other limitations or conditions (specify) __________________________________________________________________________________ 

    D.  Number of years allowed:              Year 1                  Year 2                  Year 3                  Year 4                  Year 5 (* see below)
                                              Year 6                  Year 7                  Year 8                  Year 9                   Year 10
    E.  For a statement of benefits approved after June 30, 2013, did the designating body adopt an abatement schedule per IC 6-1.1-12.1-17?
               Yes                No
  If yes, attach a copy of the abatement schedule to this form.
         If no, the designating body is required to establish an abatement schedule before the deduction can be determined.
We have also reviewed the information contained in the statement of benefits and find that the estimates and expectations are reasonable and have
determined that the totality of benefits is sufficient to justify the deduction described above.

Approved (signature and title of authorized member of designating body)  Telephone number                   Date signed (month, day, year)
                                                                         (               )
Printed name of authorized member of designating body                    Name of designating body

Attested by (signature and title of attester)                            Printed name of attester

* If the designating body limits the time period during which an area is an economic revitalization area, that limitation does not limit the length of time a 
taxpayer is entitled to receive a deduction to a number of years that is less than the number of years designated under IC 6-1.1-12.1-17.

IC 6-1.1-12.1-1
(17)     “Eligible vacant building” means a building that:
  (A) is zoned for commercial or industrial purposes; and
  (B) is unoccupied for at least one (1) year before the owner of the building or a tenant of the owner occupies the building, as evidenced
            by a valid certificate of occupancy, paid utility receipts, executed lease agreements, or any other evidence of occupation that the
            department of local government finance requires.

IC 6-1.1-12.1-17
Abatement schedules
Sec. 17.  (a) A designating body may provide to a business that is established in or relocated to a revitalization area and that receives a deduction under
section 4 or 4.5 of this chapter an abatement schedule based on the following factors:
                (1)  The total amount of the taxpayer’s investment in real and personal property.
                (2)  The number of new full-time equivalent jobs created.
                (3)  The average wage of the new employees compared to the state minimum wage.
                (4)  The infrastructure requirements for the taxpayer’s investment.
(b) This subsection applies to a statement of benefits approved after June 30, 2013.  A designating body shall establish an abatement schedule
  for each deduction allowed under this chapter.  An abatement schedule must specify the percentage amount of the deduction for each year                          
  of the deduction.  Except as provided in IC 6-1.1-12.1-18, an abatement schedule may not exceed ten (10) years.
(c) An abatement schedule approved for a particular taxpayer before July 1, 2013, remains in effect until the abatement schedule expires under
  the terms of the resolution approving the taxpayer’s statement of benefits.  

                                                                        Page 2 of 2