State Form 18865 (R11 / 10-15)
Prescribed by the Department of Local Government Finance

INSTRUCTIONS: To be filed in person or by mail by the owner of such property with the County Auditor of the county in which the property is located. A person who is no longer eligible for this deduction shall notify the County Auditor of this change. (IC 6-1.1-12-36)

FILING DATES: (1) Real Property: Must be completed and dated by December 31 of the year for which the person wishes to obtain the deduction and filed or postmarked on or before January 5 of the following calendar year.
(2) Mobile/Manufactured Home assessed under IC 6-1.1-7: Must be completed, dated, and filed during the twelve (12) months before March 31 of the year the deduction is to be effective.
(3) State Distributable Property under IC 6-1.1-8 (solar powered device only): Must be completed and dated by December 31 of the year for which the person wishes to obtain the deduction and filed on or before January 5 of the following calendar year.
(4) Personal Property under IC 6-1.1-3 (solar powered device only): Must be completed and dated by December 31 of the year for which the person wishes to obtain the deduction and filed on or before January 5 of the following calendar year. In addition to filing this form for the deduction, an applicant must also attach a Form 103-SPD to either his personal property tax return or his amended personal property tax return for each year the deduction is desired.
(IC 6-1.1-12-26; 6-1.1-12-26.1; 6-1.1-12-27.1; 6-1.1-12-29; 6-1.1-12-30; 6-1.1-12-33; 6-1.1-12-34; 6-1.1-12-35.5; 6-1.1-12-36)

All claims for a deduction filed on a geothermal or hydroelectric system or device must be accompanied by proof of certification of qualification by the Department of Environmental Management pursuant to IC 6-1.1-12-35.5.

Special Instructions

 

I (We),

Name (Last, First)

Phone

Email

certify that I (we) own or am (are) buying on contract or am (are) leasing the real property from the real property owner the following real property, mobile/manufactured home, state distributable property, or personal property that is subject to assessment and property taxation and for which a:

Type

Solar Power Device:

*Applies to a solar power device installed after December 31, 2011.

Deduction from assessed valuation is hereby claimed in county

System/device was installed on (mm-dd-yyyy)

Total deduction claimed $

Taxing District (city, town, township)

Township

Legal description or key number

If a deduction was allowed last year, have there been any changes in the property?

Parcel number

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

I (We) hereby certify that the above statement is true, correct, and complete.

Signature

Click here to sign

Date signed (mm-dd-yyyy)

1. Total assessed value of real property or mobile/manufactured home including qualifying device/system.

$

2(a). For wind; geothermal; hydroelectric; real property or mobile/manufactured home with a solar powered device: Enter the assessed valuation without the qualifying device/system.

$

2(b). For solar energy system only: Out-of-pocket expenditures for components and installation labor.

$

2(c). For personal property solar power device deduction: Enter amount calculated on Form 103-SPD.

$

2(d). For state distributable solar power device deduction: Enter assessed value of qualifying equipment.

$

3. Deduction: Line 1 minus Line 2(a); or enter the actual amount shown on Line 2(b), 2(c), or 2(d).

$

Assessment Date First Effective (mm-dd-yyyy)

Payable on (mm-dd-yyyy)

Is property recommended for deduction?

Recommended deduction

Comments, if any

Signature of assessing official

Click here to sign

Printed name of assessing official

Date signed (mm-dd-yyyy)

Deduction determined by County Auditor for assessment date
(mm-dd-yyyy)

Payable on
(mm-dd-yyyy)

Approved deduction
$

Signature of county auditor

Click here to sign

Name of county auditor

Date signed (mm-dd-yyyy)

Description or reasons for change:

Distribution on date of filing: Original - County Auditor; File stamped copy - Applicant; File stamped copy - Township Assessor, if any, or County Assessor
Distribution on date that determination is made: Original - County Auditor; Copy - Applicant; Copy - Township Assessor, if any, or County Assessor

See Special Instructions