State Form 17592 (137R) "Petition for Survey and Reassessment - Real and Personal Property Partially or Totally Destroyed by Disaster" - Indiana

What Is State Form 17592 (137R)?

This is a legal form that was released by the Indiana Department of Local Government Finance - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2010;
  • The latest edition provided by the Indiana Department of Local Government Finance;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of State Form 17592 (137R) by clicking the link below or browse more documents and templates provided by the Indiana Department of Local Government Finance.

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Download State Form 17592 (137R) "Petition for Survey and Reassessment - Real and Personal Property Partially or Totally Destroyed by Disaster" - Indiana

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PETITION FOR SURVEY AND REASSESSMENT -
FOR OFFICE USE ONLY
FORM 137R
REAL AND PERSONAL PROPERTY PARTIALLY
OR TOTALLY DESTROYED BY DISASTER
State Form 17592 (R7 / 12-10)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:
This form must be filed with the County Assessor. It is recommended that taxpayers file this petition within twelve (12) months of the disaster;
however, petitions may be accepted by the County Assessor at any time, as long as compliance with IC 6-1.1-4-11(b) can be achieved.
Pursuant to IC 6-1.1-4-11, the undersigned hereby petitions the County Assessor for a survey and reassessment of improvements and personal property
described below. (Description must match legal description on Tax Bill Duplicate.)
Name of taxpayer (first, middle, last)
Telephone number after disaster
(
)
Address of taxpayer after disaster (number and street, city, state, and ZIP code)
Kind of disaster
Date of disaster (month, day, year)
County
Township
Parcel number
Section
Range
Lot number
Block
Addition
Location of property destroyed (number and street or Rural Route, city, state and ZIP code)
Do not complete unless a reassessment is ordered.
REAL PROPERTY REASSESSMENT
TYPE OF
ASSESSED VALUE OF
PERCENT OF
DATE
REASSESSMENT
STRUCTURE
(month, day, year)
(TOWNSHIP ASSESSOR)
IMPROVEMENTS
DAMAGE
$
$
TOTAL
Do not complete unless a reassessment is ordered.
BUSINESS PERSONAL PROPERTY REASSESSMENT
TYPE OF
DATE
REASSESSMENT
PERCENT OF
ASSESSED VALUE
PROPERTY
DAMAGE
(month, day, year)
(TOWNSHIP ASSESSOR)
$
$
AFFIDAVIT
I, under oath, hereby declare that the statements contained in this petition are true and correct and constitute the basis for the survey and reassessment.
Signature of taxpayer
Name of taxpayer (please print or type)
Date signed (month, day, year)
Signature of assessor
Name of assessor (please print or type)
Date signed (month, day, year)
COUNTY ASSESSOR ACTION
Surveyor
Date of survey (month, day, year)
Ordered reassessed?
Date ordered reassessed (month, day, year)
Yes
No
Remarks
DISTRIBUTION: Original - County Assessor; Copy - Township Assessor, if applicable; Copy - Taxpayer
Reset Form
PETITION FOR SURVEY AND REASSESSMENT -
FOR OFFICE USE ONLY
FORM 137R
REAL AND PERSONAL PROPERTY PARTIALLY
OR TOTALLY DESTROYED BY DISASTER
State Form 17592 (R7 / 12-10)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:
This form must be filed with the County Assessor. It is recommended that taxpayers file this petition within twelve (12) months of the disaster;
however, petitions may be accepted by the County Assessor at any time, as long as compliance with IC 6-1.1-4-11(b) can be achieved.
Pursuant to IC 6-1.1-4-11, the undersigned hereby petitions the County Assessor for a survey and reassessment of improvements and personal property
described below. (Description must match legal description on Tax Bill Duplicate.)
Name of taxpayer (first, middle, last)
Telephone number after disaster
(
)
Address of taxpayer after disaster (number and street, city, state, and ZIP code)
Kind of disaster
Date of disaster (month, day, year)
County
Township
Parcel number
Section
Range
Lot number
Block
Addition
Location of property destroyed (number and street or Rural Route, city, state and ZIP code)
Do not complete unless a reassessment is ordered.
REAL PROPERTY REASSESSMENT
TYPE OF
ASSESSED VALUE OF
PERCENT OF
DATE
REASSESSMENT
STRUCTURE
(month, day, year)
(TOWNSHIP ASSESSOR)
IMPROVEMENTS
DAMAGE
$
$
TOTAL
Do not complete unless a reassessment is ordered.
BUSINESS PERSONAL PROPERTY REASSESSMENT
TYPE OF
DATE
REASSESSMENT
PERCENT OF
ASSESSED VALUE
PROPERTY
DAMAGE
(month, day, year)
(TOWNSHIP ASSESSOR)
$
$
AFFIDAVIT
I, under oath, hereby declare that the statements contained in this petition are true and correct and constitute the basis for the survey and reassessment.
Signature of taxpayer
Name of taxpayer (please print or type)
Date signed (month, day, year)
Signature of assessor
Name of assessor (please print or type)
Date signed (month, day, year)
COUNTY ASSESSOR ACTION
Surveyor
Date of survey (month, day, year)
Ordered reassessed?
Date ordered reassessed (month, day, year)
Yes
No
Remarks
DISTRIBUTION: Original - County Assessor; Copy - Township Assessor, if applicable; Copy - Taxpayer