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About Us > Preservation Initiatives > Recent Past Submission Form

Fill out a survey form for each structure that you think merits consideration as a Landmark of the Recent Past, then click Submit..


This form may be submitted electronically, printed and mailed or faxed to:
Indiana Landmarks

340 West Michigan Street
Indianapolis, IN 46202
Fax: 317-639-6734

 
Form submitted by:
Name:
Title:
Company/Organization:
Street address:
County Name (Indiana Only):
City:
State/Province:
Zip/Postal code:
Phone:
Fax:
E-mail (required):
Historic Landmarks member: Yes No

Building information:
Building Name:
Address:
City:
County:
Zip code:
Year of construction:
Architect:
Builder/Contractor:
Building type:
In National Register: Yes
In National Register District: Yes
Brief description of building:
Building history: .
Photos: Do you have photos we can contact you for?
Yes

Building owner (if known):
Name:
Address (if different):
City:
State:
Zip code:
Phone:
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