Fillable Printable Form 55183

Form 55183

PRIVACY NOTICE

The cost and any specific individual’s

salary information is confidential; the

balance of the filing is public record

per IC 6-1.1-12.1-5.1 (c) and (d).

20____ PAY 20____

FORM CF-1 / VBD

COMPLIANCE WITH STATEMENT OF BENEFITS

VACANT BUILDING DEDUCTION

State Form 55183 (2-13)

Prescribed by the Department of Local Government Finance

TAXPAYER INFORMATIONSECTION 1

LOCATION AND DESCRIPTION OF PROPERTYSECTION 2

EMPLOYEES AND SALARIESSECTION 3

AS ESTIMATED ON SB-1 ACTUAL

Current number of employees

Number of employees retained

Number of additional employees

Salaries

ACTUAL

COST AND VALUESSECTION 4

SECTION 5

TAXPAYER CERTIFICATIONSECTION 6

I hereby certify that the representations in this statement are true.

Signature of authorized representative Title Date signed (month, day, year)

UPDATES TO THE ANSWERS PROVIDED IN SECTION 5 OF THE FORM SB-1/VBD, IF ANY

(Attach additional sheet(s) if necessary.)

Values before project

Plus: Values of proposed project

Less: Values of any property being replaced

Net values upon completion of project

Plus: Values of proposed project

Less: Values of any property being replaced

Net values upon completion of project

Values before project

COST

ASSESSED VALUE

AS ESTIMATED ON SB-1

EMPLOYEES AND SALARIES

REAL ESTATE IMPROVEMENTS

COST AND VALUES

( )

Name of taxpayer

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

Name of contact person

County

DLGF taxing district number

Telephone number

Name of designating body

Location of property

Description of eligible vacant building that the property owner or tenant will occupy

Resolution number Estimated occupancy date (month, day, year)

Actual occupancy date (month, day, year)

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

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

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ASSESSED VALUE

Propery owners must file this form with the county auditor and the designating body for their review regarding the

compliance of the qualifying property with the Statement of Benefits (Form SB-1/VBD).

This form must accompany the initial deduction application (Form 322/VBD) that is filed with the county auditor.

This form must also be updated each year in which the deduction is applicable. It is filed with the county auditor and

the designating body before May 15, or by the due date of the real property owner’s personal property return that is

filed in the township where the property is located. (IC 6-1.1-12.1-5.1(b))

INSTRUCTIONS:

This statement is being completed for real property that qualifies under the following Indiana Code (check one box):

Eligible vacant building (IC 6-1.1-12.1-4.8)

Enhanced eligible vacant building (IC 6-1.1-12.1-16)

Reset Form

OPTIONAL: FOR USE BY A DESIGNATING BODY WHO ELECTS TO REVIEW THE COMPLIANCE WITH THE FORM SB-1/VBD

INSTRUCTIONS: (IC 6-1.1-12.1-5.1 and IC 6-1.1-12.1-5.9)

Not later than forty-five (45) days after receipt of this form, the designating body may determine whether or not the property owner has substantially complied

with the Statement of Benefits (Form SB-1/VBD).

If the property owner is found NOT to be in substantial compliance, the designating body shall send the property owner written notice. The notice must include

the reasons for the determination and the date, time, and place of a hearing to be conducted by the designating body. The date of this hearing may not be

more than thirty (30) days after the date this notice is mailed. A copy of the notice may be sent to the county auditor and the county assessor.

Based on the information presented at the hearing, the designating body shall determine whether or not the property owner has made reasonable efforts to

substantially comply with the Statement of Benefits (Form SB-1/VBD) and whether any failure to substantially comply was caused by factors beyond the control

of the property owner.

If the designating body determines that the property owner has NOT made reasonable efforts to comply, then the designating body shall adopt a resolution

terminating the property owner’s deduction. If the designating body adopts such a resolution, the deduction does not apply to the next installment of property

taxes owed by the property owner or to any subsequent installment of property taxes. The designating body shall immediately mail a certified copy of the

resolution to: (1) the property owner; (2) the county auditor; and (3) the county assessor.

We have reviewed the CF-1 and find that:

the property owner IS in substantial compliance

the property owner IS NOT in substantial compliance

other (specify):

Reasons for the determination (attach additional sheets if necessary):

If the property owner is found not to be in substantial compliance, the property owner shall receive the opportunity for a hearing. The following date and

time has been set aside for the purpose of considering compliance. (Hearing must be held within thirty (30) days of the date of mailing of this notice.)

HEARING RESULTS (to be completed after the hearing)

Approved Denied (see instruction 4 above)

Reasons for the determination (attach additional sheets if necessary):

APPEAL RIGHTS [IC 6-1.1-12.1-5.9(e)]

A property owner whose deduction is denied by the designating body may appeal the designating body’s decision by filing a complaint in the office of the

Circuit or Superior Court together with a bond conditioned to pay the costs of the appeal if the appeal is determined against the property owner.

Page 2 of 2

Signature of authorized member

Attested by: Designating body

Date signed (month, day, year)

Time of hearing Date of hearing (month, day, year) Location of hearing

Signature of authorized member

Attested by: Designating body

Date signed (month, day, year)