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STATEMENT OF BENEFITS FORM SBA 1 PP <br />PERSONAL PROPERTY <br />.� State Form 51764 (R 11 -06) PRIVACY NOTICE <br />' ■�• Prescribed by the Department of Local Government Finance The cost and any specific individual's <br />salary information is confidential; the <br />balance of the filing is public record <br />per IC 6 -L1- 12.1 -5.t (c) and (d). <br />INSTRUCTIONS, <br />1. This statement must be submitted to the body designating the Economic Revitalization Area prior to the public hearing if the designating body requires <br />information 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 installs the new manufacturing equipment and /or research and development equipment, anc!!or logistical distribution <br />equipment and/or information technology equipment for which the person wishes to claim a deduction. 'Projects" planned or committed to after July 1, 1987, <br />and areas designated after July 1, 1987, require a STATEMENT OF BENEFITS. (iC 6-1.1 -12.1) <br />2. Approval of the designating body (City Council, Town Board, County Council, etc.) must be obtained prior to installation of the new manufacturing equipment <br />and /or research and development equipment and /or logistical distribution equipment and /or information technology equipment, BEFORE a deduction may <br />be approved. <br />3. To obtain a deduction, a person must File a certified deduction schedule with the person's personal property return on a certified deduction schedule (Form 103 - <br />ERA) with the township assessor of the township where the property is situated. The 103 -ERA must be filed between March 1 and May 15 of the assessment <br />year in which new manufacturing equipment and /or research and development equipment and /or logistical distribution equipment and /or information technology <br />equipment is installed and fully functional, unless a filing extension has been obtained. A person who obtains a filing extension must file the form between <br />March 1 and the extended due date of that year. <br />4. Property owners whose Statement of Benefits was approved after June 30, 1991, must submit Form CF -1 /PP annually to show compliance with the Statement <br />of Benefits. (IC 6 -1.1- 12,1 -56) <br />5. The schedules established under IC 6 -1.1- 12.1 -4.5 (d) and (e) apply to equipment installed after March 1, 20por equipment installed prior to March 2, <br />2001, the schedules and statutes in effect at the time shall continue to apply. (1C 6- 1.1- 12.1 -4,5 (t) and (g))_ j <br />axpayer <br />rporation dlbfa f3HS Strings (or Subsidiary) <br />7ddress <br />f taxpayer (number and str eet, city, state and ZIP code) <br />2813 Wilber Ave., Bathe Creek, Michigan 49075 <br />Name of contact person one number <br />Russell McFee, President <br />..,. (269) 968 -3351 <br />• s 1101,21=033MERMINEW <br />Name of designating body Resolution number (s) <br />Common Council the City South Bend"" ` ( ) <br />of of <br />Location of property County <br />DLGF taxing district number <br />6679 Enterprise Drive, South Bend, Indiana 46628 St. Joseph <br />009 (SB- German) <br />Description of manufacturing equipment and/or research and development equipment <br />ESTIMATED <br />and /or logistical distribution equipment and /or information technology equipment <br />Start Date COMP letion Date <br />(use additional sheets if necessary) <br />Manufacturing Equipment <br />February 2011 February 2013 <br />Proposed installation of string manufacturing and related equipment including, without R & D Equipmentt <br />limitation, automated ball -end machine(s) and computer monitored string tension and <br />finding equipment, having an original cost in excess of $650,000. Logist Dist Equipment <br />IT Equipment <br />s s s • "s <br />Curren t number Salaries Number retained umber additional Salaries <br />=fariesN' <br />0 -$0.00 NIA 15 -20 — $35Qk -$500k <br />NOTE: Pursuant to IC 6 -1.1- 12,1- 5.1(d)(2) the MANUFACTURING R g D EQUIPMENT LOGIST DIST <br />EQUIPMENT EQUIPMENT IT EQUIPMENT <br />Assessed Assessed Ad Assessed <br />Cost COST of the property is confidential. Cost !Assessed Cost <br />os Cost <br />Value Value <br />Value Value <br />Current values <br />0 <br />0 <br />Plus estimated values of proposed project <br />$6000 <br />Reg. 16 <br />Less values of any property being replaced <br />N/A <br />NIA <br />Net estimated values upon completion of project <br />$60oK- <br />Reg. 16 <br />$1MM <br />Estimated solid waste converted (pounds) <br />Estimated hazardous waste converted (pounds) <br />Other Benefits: <br />• E MM 17M 0 • <br />hereby ce qify that the rep resentations in this statement are true. <br />Si re of autho re tine <br />�,G <br />Title <br />Russell McFee, President <br />Date sfgnemonth, day, year) <br />N 2010 <br />