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``•~~~~ S~'fi~Et~EI~~ ©F BEf~EF6~'S <br />~~ State Fomi 2i 167 (R7 ! ?2-0? ) <br />Prescribed by the Department of Lacal Government Finance <br />~~~~~ <br />•a.~ <br />FORtl4 <br />.SB-~ <br />INSTRUCTIONS: <br />i. This statement must be submitted fo the body designating the economic revitalization area prior to the public hearing if the designating body requires infor- <br />mation from the applicant in making its decision about whether to designate an Economic Revitalization Area. Otherwise this statement must be submitted <br />to the designating body BEFORE a person instaNs the new manufacturing equipment and ! or research and development equipment, yr BEFORE the <br />redevelopment or rehabilitation of real property for which the person wishes to claim a deduction. "Projects" planned or committed to after July 1, 1987 and <br />areas designated after July 1, i 987 require a STATEMENT OF BENEFITS. (IC 6-1.1-f 2. i) <br />2. Approval of the designating body (City Council, Town Board, County Council, etc.) must be obtained prior to initiation of the redevelopment or rehabilitation, <br />or prior to installation of the new manufacturing equipment and ! or research and development equipment, BEFORE a deduction may be approved. <br />3. 70 obtain a deduction, Form 322 ERA, Real Estate Improvements and / or Fomr 322 ERA l PPME and ! or 322 ERA I PPR & DE, must be fled with the <br />county auditor. With respect to rest property, Form 322 ERA must be fried by the later of.• (i) May 10; or {2 thirtyy (30J days alter a notice of increase in real <br />property assessment is received from the township assessor. Form 322 ERA 1 PPME and l or 322 ERA PI~R & DE must be filed between March 1 and May <br />75 of the assessment year in which new manufacturing equipment and l or research and development equipment becomes assessable, unless a filing <br />extension has been obtained. A person who obtains a filing extension must file the form between March 1 and the extended due date of that year. <br />4. Property owners whose Statement of Benefits was approved aRer June 30. 199 i must submit Form CF - i annually to show compliance with the Statement <br />of Benefits. (1C 6-i. i-12. i-5.6) <br />5. The schedules established under IC 6-1.1-12.1-4(dj and lC 6-1.1-12.1-4.5 (ej effective July 1, 2000 apply to any statement of benefits filed ort or after <br />July 1, 2000. <br />The schedules effective prior fo July f, 2000 shall continue to apply to those statement of benefits filed before July f, 2000. <br />• ~- • <br />Name of taxpayer <br />~Cc,JOAt,I, WF tss ~ LLP <br />Address of taxpayer (street and number, city, state and ZIP code) <br />vZ8 EAsT ~EFt~tS,on.) f39Vt~~Arl-n ~ ~vrt+ QED, t ~.1 4Coto17 <br />Name of contact pe on ,,1j'~ ,-1 <br />~j~tf}tJ /((~tt~..>=1L Vtt:E P26StD~i of ('p~R,q•~-ior.~ yV~tss ~~^6S Telephone number <br />(5~4) 234-7373 <br />•. ~ •-. <br />Name of designating body Resolution number <br />O~/TFI' ~f-+uID ~MM~ti1 ~nlGll.r <br />Locafton of property <br />~ flZ .nt= ` 4 Ste- ~Z, 'r37 rJ fLZE County <br />S~ . J~SE.Pt-F~ Taxing district <br />a2,-' T~w~ <br />Description of real property improvements and 1 or new manufacturing equipment and 1 or ESTIMATED <br />research and development equipment (use additional sheets if necessary) Start Date Completion Date <br />ViuPER~J~wP~ F~Na V'~Ga~tt' pa.oaty~-ry ~,~1~~- a~- <br />Real Estate <br />~~~ Zp,~' ~~~~ zt~ <br />- <br />f <br />o <br />pE~/E~oP60 tf3s <br />o NUJ 5u~1GLE.-FA~tt.~ {-hM~S. <br />tJFRAsT~Utrv~2! lMp~oVlrMt.w!'I-S t~"~ t ~t-~v~E- M~M/ New Mfg Equipment <br /> <br />Gvl26S ~ StDE.wALKS ~ v~lATER TAPS ~A AwE-f RE~SVRF~-1 R 8 DE <br /> <br /> <br />Current number Salaries Number retained Salaries <br />- <br />NA <br />1 A <br />~ Number additional Salaries <br />J <br />J~ <br />t <br />- <br />t <br />A N~4 n n <br />~ h <br /> <br />NOTE: Pursuant to IC 6-1.1-12.1-5.1 (d) (2) the Real Estate Improvements Machinery Research and Development <br />Equipment <br />COST of the property is confidential. Cost Assessed Value Cost Assessed Value Cost Assessed Value <br />Current values <br />Pius estimated values of proposed project ~ (70 000 <br />less values of any property being rep}aced ' ~} <br />Net estimated values upon completion of project } 17C, 000 <br />• • . . • - • <br /> <br />Estimated solid waste converted (pounds} ~ Estimated hazardous wa cop ertrre~~~~i /[w~r'Q~u[p'~t ~~ <br />~- <br />Other benefits: ~/.~ <br />7 <br />~.1 ~ ~ ~ . r., ..'1 <br /> <br /> <br />• • <br />I hereb certi that the re resentations in this statement are true. <br />Signature of authorized representative Title e signed (month, day, year) <br />Dat <br /> ~i c <br />d <br />