Application For Deduction From Assessed Valuation Of Rehabilitated Property (Form 322A) {49567}

APPLICATION FOR DEDUCTION FROM ASSESSED VALUATION OF REHABILITATED STRUCTURES OVER FIFTY (50) YEARS OLD State Form 49567 (R6 / 11-16) 20___ PAY 20___ FORM 322A Prescribed by the Department of Local Government Finance SPECIAL NOTE: No new deductions for the rehabilitation of structures over fifty (50) years old under IC 6-1.1-12-22 may be granted after the January 1, 2017 assessment date. INSTRUCTIONS: Application must be filed with the county auditor in person or by mail in the year in which the addition to the assessed value is made. If notice of the addition to assessed value is not given to the property owner before December 1 of that year, this form may be filed not later than thirty (30) days after the date of the mailing of the notice. This deduction is for buildings or structures (does not include land) that were erected at least fifty (50) years prior to this application. County Township DLGF taxing district number The undersigned owner hereby applies to the County Auditor, pursuant to IC 6-1.1-12-22 through IC 6-1.1-12-24, for a deduction from the increase in assessed valuation resulting from rehabilitation of the following described property: Name of owner Year building or structure originally erected Type of dwelling: Address of property (number and street, city, state, and ZIP code) Date of rehabilitation (month, day, year) Kind of rehabilitation: Cost of rehabilitation Single family dwelling Other Township Block number Significant Repairs LEGAL DESCRIPTION AS FOUND ON TAX DUPLICATE Range Replacements Addition Key or parcel number Improvements Section Lot number ASSESSED VALUE AFTER REHABILITATION (IMPROVEMENTS ONLY) ASSESSED VALUE PRIOR TO REHABILITATION (IMPROVEMENTS ONLY) DIFFERENCE IN ASSESSED VALUE (IMPROVEMENTS ONLY) INCREASE IN A/V DUE TO REHABILITATION * (DEDUCTION CLAIMED) * The assessed value (A/V) eligible for the deduction is the increase in A/V resulting from the rehabilitation and does not include the increase in A/V which resulted from the reassessment of the entire property. CERTIFICATION I hereby certify that the representations on this application are true. Signature of owner Address (number and street, city, state, and ZIP code) Name of owner (print or type) Date (month, day, year) VERIFICATION BY ASSESSING OFFICIAL 1. Type of structure 2. Date erected (month, day, year) 3. Date rehabilitated (month, day, year) 4. Date reassessed (month, day, year) 5. Date taxpayer notified of increase in assessed valuation (month, day, year) 6. Assessed valuation of improvements AFTER rehabilitation 7. Assessed valuation of improvements PRIOR TO rehabilitation 8. Amount of INCREASE attributed to rehabilitation * 9. Date verified (month, day, year) REDUCTION CALCULATION BY AUDITOR 1. Amount of INCREASE attributed to rehabilitation (Same as #8 on left) * 2. 50% of #1 above 3. Maximum annual deduction (For single family dwellings - $124,800; for other structures - $300,000.) 4. Annual deduction (Lesser of #2 or #3) 5. Date deduction approved (month, day, year) 6. First year of deduction (Year in which taxes on rehabilitated portion of property became payable.) 7. Fifth year of deduction NOTE: Owner must have paid at least $10,000 for the rehabilitation. A general reassessment or a cyclical reassessment which occurs within the five (5) year period of the deduction does not affect the amount of the deduction. (IC 6-1.1-12-22 and IC 6-1.1-12-23) Signature of assessing official Signature of county auditor American LegalNet, Inc. www.FormsWorkFlow.com