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FORM SE-1 I PP <br />ST, ATEMENT <br />OF BENEFffS <br />N PERSONAL PROPERTY <br />State form 517 64 (R 1 ubi PRIVACY tt��'tC� _ <br />Presrxibed by t eepalrent otL3cai C,overr� in ,t FirarCe <br />T,e ces ±and any spadCc Indif %idfla 's <br />s&ia y i o maGc {s ca,nfidenbea , tFe <br />! balan,e of the filing is public recor b <br />icr iC <br />[NSTRUCTIONS: <br />1. This statement must be subrri tcd is the body desi9r a*fng the f�convmic FRevfafization Area prior to the public Rearing if the cEesieJnatlng body requires <br />information from The applicant ill malting its decision abcr! whether to desfgnate aP Economic Revrtalizar on Arxc. Otheiwise this statement must be submitted <br />fo the designating body BEFORE a person .instalts tiro new manufacturing equrprrren# and/or ras�arcrr and devefoprrient euuipaicrit, and/or toy sdcai distdbutiorr <br />1887, <br />equipment andlor informatfort technology equipment for wrF ch Fha person wishes to daim a deduction. `projects "planned ar committed to after July 1, <br />and areas designated after July 1, 1987. require a STATEMEiVTOFBEtrEFfTS. (fC 6- 1.1-12.9) <br />2. Apprnxfaf of the designating body (City Council, Town Board, Caur iy' unrsna f, etc-) nusl be ohtarned prior to Installation of the nekv manufacturing egwpmennt <br />andlor research and devsfopn)ent equipment and /or faaisti „at distribution equipmerH and /ar rnfunrtation technology equipment. BEFORE a deduction may <br />be approved <br />3. To obtain a deduction, a person musi file a certified deduction schedule with the parson's personal pro_Dc-fly return on a certified deduction schedule (Form <br />903 -ERA} with the tpsvrrship assessor of the township ev tore tt a property is situated. The 103-F RA must be fled between March 7 and P,day 15 of the <br />assessment year fn which new manufacturing equiprnenf andlor research and devalopmert equipment andlor logistical distribution equipment andlor <br />information technology equipment is installed and rulfy functional, unless a filing extension has been obtained. A person wflfl obtains a fifinq extension must <br />Ne the form between March 9 and the extended due date of thist yaar. <br />4. Prop&rty owners whose Statement of 8enof is was approved after Jung 30, 9999, must submit Fornt CF -9 / PP annuafly to show compliance with the <br />Statement of Benefits. <br />5- The schedules established under fC B- 7.1-12- 1-4,5(d} and' (e) apply to equipment lnstalied aRer 03mh 1,. 2001. For equipment installed prior to Uamh 2, <br />20101, the schedules and statutes !n effect at the nine shad continue b apply. ((C 6 7,Y -12. f- 4.5(rJ and (g)) <br />Other +benefits', <br />! hereby codify that the representations in this statement are true. <br />Ttic Date signed {month, day, year) <br />r I �d2cSi'�J T � l dfbo <br />