18-20 Confirming Property Tax Abatement Petition - Franklin Street Technology Park, LLC

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�^`°"• STATEMENT OF BENEFITS Filed in Clerk's Office 20_PAY 20_ REAL ESTATE IMPROVEMENTS i FORM SB-1/Real Property State Form 51767(R6/10-14) MAR 2 9 2018 ' Prescribed by the Department of Local Government Finan a PRIVACY NOTICE This statement is being completed for real property that qualifies under th L-4) Indiana Code check one box): Any information concerning the cost of the property and specific salaries [�Redevelopment or rehabilitation of real estate improvements(IC 6-1.1AREEMAi-i FOWLER paid to indmdual employees by the Residentially distressed area(IC 6-1.1-12.1-4.1) LERK,SOUTH BEND IN property owner is confidential per BEND, IC 6-1.1-owner.1. INSTRUCTIONS: 1. This statement must be submitted to the body designating the Economic Revitalization Area prior to the public hearing if the designating body requires Information from the applicant in making its decision about whether to designate an Economic Revitalization Area. Otherwise,this statement must be submitted to the designating body BEFORE the redevelopment or rehabilitation of real property for which the person wishes to claim a deduction. 2. The statement of benefits form must be submitted to the designating body and the area designated an economic revitalization area before the inflation of the redevelopment or rehabilitation for which the person desires to claim a deduction. 3. To obtain a deduction,a Form 3221RE must be filed with the County Auditor before May 10 in the year in which the addition to assessed valuation is made or not later than thirty(30)days after the assessment notice is mailed to the property owner if it was mailed after April 10. A property owner who failed to file a deduction application within the prescribed deadline may file an application between March land May 10 of a subsequent year 4. A property owner who files for the deduction must provide the County Auditor and designating body with a Form CF-!/Real Property. The Form CF-!/Real Property should be attached to the Form 3221RE when the deduction is first claimed and then updated annually for each year the deduction is applicable. IC 6-1.1-12.1-5.1(b) 5. For a Form SB-1/Real Property that is approved after June 30, 2013, the designating body is required to establish an abatement schedule for each deduction allowed. For a Form SB-!/Real Property that is approved prior to July 1, 2013, the abatement schedule approved by the designating body remains in effect. IC 6-1.1-12.1-17 SECTION TAXPAYER INFORMATION Name of taxpayer Franklin Street Technology Park LLC Address of taxpayer(number and street city,state,and ZIP code) 814 Marietta Street South Bend, IN 46601 Name of contact person Telephone number E-mail address Anne Hayes ( 574 ) 233-1296 ahayes @telecom park.corn Name designating body Resoluticr:ncmGer of d Location of property County DLGF taxing district numbw 900 Franklin Street St Joseph Description of real property improvements,redevelopment,or rehabilitation(use additional sheets if necessary) Estimated start date(month,day,year) SEE ATTACHED July 2018 Estimated completion date(month,day,year) July 2022 HOW Was MKIL01 Current number Salaries Number retained Salaries Number additional Salar es 0.00 0.00 REAL ESTATE IMPROVEMENTS COST ASSESSED VALUE Current values 84,000.00 Pius estimated values of proposed project 3,000,000.00 Less values of any property being replaced Net estimated values upon completion of project a'.000.00 Estimated solid waste convened(pounds) Estimated hazardous waste converted(pounds) Other benefits SECTION I hereby ceitify that the representations in this statement are true. Signature of authorized reprsen Date signed(month,day,year) — / 103/28/2018 Printed name uthorized representative Title Anne Hayes Member Page 1 of 2