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~°"~'~~'~- <br />.r~~ APPLICATION F'OR DEDUCTION FROh~ A <br />01= STRUCTURES IN ECONOMIC REVITA <br />~~ -,~)' State Form 18379 {Rt01 ifl-fl8) <br />F.i J <br /> <br />+iis Prescribed by the bepartment of Local Government Finance <br />i. ti::4 t.~,~ <br />~~`'~~ <br />L~ATION , ~~ 20_ PAY z8 <br />:AS ~EF~A~~~` -. <br />~ t' ~ FORAiI 322 ! RE <br />1 `~ LJ ,,, p <br />lNSTRUCTtpfVS: '"LM1 ~_t-~"~, ..M ~^,a.. <br />1. This form is to be filed !n person or by marl with the Auditor of the county in whi the p pert~ipsjatated before May i0 of the year in which addition to <br />assessed valuafion (or new assessorentJ is made, nr not later than thirty (30) day after mail,Qag,}jefe of notice of assessment (Form i1 J if such notice is <br />not given before April 10 of that year (lC 8-i. i-12.1-5}. .` <br />2. Copy of Form 17 must be attached. <br />3. A property owner may not receive this deducfion for the same property or rmprovemenfs for which a deduction is obtained under either 1C 6-1.1-12-18, <br />IC 6-1,1-i2-22 or lC 8-1.1-12-28.5 (!C fi-1.1-12.1-5}. <br />4. A copy pf the statement of benefits (Form 58-1 / Rea! Property} must be attached to this application. <br />5. The compliance wNh statement of benefrfs (Form CF-i /Beat Property} must be filed with this application and the designating body (IC 6-1.1-12. i-5.1}, <br />6. A cagy of the resolution must be attached to this application. <br />7. Please sae lC 6-1.1-12.1 far furtherrnstrucfrons. <br />8. Taxpayer completes 5ecfions 1, 11 and tq below. <br />9. If property located in an economic revitalization area is also located in an allocation area as defined in !C 36-7-74-39 pr 1C 3fi-7-15. i-2fi, an application <br />for the property tax deduction may not be approved unless the Commission thaf designated the aliacatron area adopts a resolution approving the <br />application (iC fi-1.1.92. i-2(kJ}. <br />i D. Except for ERA's designated before December 31, 1987, a deduction for redevelopment or rehabilitation is not authorized for the following facilities <br />(1C fi-1.1-12. i-3}. <br />a. Private or commercial golf cpurse j. Any facility, fhe primary purppse of which is (a} Retail food and <br />b. Country club beverage service; (bJ Automobile sales ar service; ar (c} other <br />c. Massage parlor retail; (unless the facility is located in an economic deve opment- <br />target area established under !C 6-1. i-12.1-7}. <br />d. Tennis court k. Residential, unless the facility is a multi_family facility that <br />e. Strafing facilrty, inGudrng roller skating, skateboarding or ice skating contains at least 20% of the units available for use by low and moderate <br />f. Racquet sport facility (including handball or racquet ball court} income rndfvrduals or unless the facility is located in an <br />g. Hot tub facility economic development target area established under !C 6-1. i-12. i-7, ar <br />h. Suntan facility the area is designated as a resrdentia!!y distressed area which <br />is required to meet conditions as cried rn lC 8-1.1-i2.1-2 (cJ (T 8 2}. <br />i. Racetrack <br />1. Package liquor store (see iC fi-1.1-12. i - 3(e}(12)] <br /> etc ~ IC)N [ - CESCRIPTION OF PROPERTY <br />The owner hereby applies to the County Auditor for a deduction pursuant to IC 6-1.1-12.1-5 beginning with the assessment date March 1, 20 11 . <br />County Township L7LGF taxing district numier Key number <br />St. Joseph Portage 018-5147-3766 <br />Name of owner <br />Snyder Custom Builders, Inc. <br />Property address (number and streef, city, state, and ZtP code) <br />727 East Corby Street, South fiend, IN 46617 <br />Legal description irorn Form 11 <br /> <br />t_ot 135 8 part of t_at 136, Sorin's 2nd Addition Date of Form 11 (month, day, yaarJ <br />Type of structure <br />Use of structure <br />Single family residence <br />Single Family Residential <br />Governing body that approved ERA designation Resolution numbor <br />South Bend Common Council <br />Date ERA designation approved (must ba before March 1) <br />SECTION 1I - VERIFICATION OF OWNER OR REPRESENTATIVE <br />Signs of owner or representativ (f hereby c rty thaf the representations an this application are true) Da <br />te 'gned (m nth, day, year} <br />p <br />G ~~ ~O <br />Ad ices (number nd str t, d1ty, scat nd ZIP rode) <br />P.O, Box 6035, South Ben , IN 46660 <br />SECTION 111-STRUCTURES ~ o , <br />A. Rehabilitation structure 1. Assessed valuation AFTER rehabilitation $ <br />2. Assessed valuation at 10D% of TTV BEFORE rehabilitation $ <br />3. INCREASE in assessed valuation $ <br />4. Assessed valuation eligible far deduction $ <br />B. New structure 1, Assessed valuation $ <br />2. Assessed valuation elig'sble for doduction $ <br />SECTION IV -VERIFICATION OF ASSESSING, OFFICIAL <br />f verify that the above described structure was assessed and the owner was notified on with the <br />effective date of the assessment being March 1, 2D and that the assessed valuations in Section III are correct. <br />Signature of Assessing Ottrcial Township Date (month, day, year} <br />CONT1iVt1ED ON THE REVERSE 51DE <br />