Designating Tax Abatement - 220 Colfax

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... -,�, STATEMENT OF BENEFITS j(a REAL ESTATE IMPROVEMENTS t 1 State Form 51767 (R2 11-07) Prescribed by the Department of Local Government Finance AsyW,,,." " This statement is being completed for real property that qualifies under the following Indiana Code (check one box): ARedevelopment or rehabilitation of real estate improvements (IC 6 -1.1- 12.1 -4) ❑ Eligible vacant building (IC 6 -1.1- 12.1 -4.8) 20_ PAY 20_ FORM SS -1 I Real Property 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. "Projects" planned or committed to after July 1, 1987, and areas designated after July 1, 1987, require a STATEMENT OF BENEFITS. (iC 6 -1.1 -12.1) 2. Approval of the designating body (City Council, Town Board, County Council, etc.) must be obtained prior to initiation of the redevelopment or rehabilitation, BEFORE a deduction may be approved. 3. To obtain a deduction, application Form 322 ERA/RE or Form 322 ERA/VBD, Whichever is applicable, must be filed with the County Auditor by the later of- (1) May 10; or (2) thirty (30) days after the notice of addition to assessed valuation or new assessment is mailed to the property owner at the address shown on the records of the township assessor. 4 Property owners whose Statement of Benefits was approved after June 30, 1991, must attach a Form CF -1 /Real Property annually to the application to show compliance with the Statement of Benefits. (IC 6 -1.1- 12.1- 5.1(b) and IC 6 -1.1- 12.1- 5.36)] 5. The schedules established under IC 6 -1.1- 12.1 -4(d) for rehabilitated property and under IC 6 -1.1- 12.1- 4.8(i) for vacant buildings apply to any statement of benefits approved on or after July 1, 2000. The schedules effective prior to July 1, 2000, shall continue to apply to a statement of benefits filed before July 1, 2000. SECTION •- • Name of taxpayer 601 {Ac -FIA& Address of taxpayer (number and street, city,. state, and ZiP code) I 1�0• fox 133! Svk / �%Iz7 /4 Name of contact person Telephone umber Jim lasko�vski 57 zi7• IM E� mail address IAskvwsk,r�'hv11�( SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT Name of designating body Hollwk l 1*,4,ly-t z' Resolution number 3 � 9 1-( — o Location of property 22o W all •F hw• Smw-1 *� County 5�• jpw DLGF taxing district number �,-- Description of real property improvements. redevelopment, or rehabilitation (use additional sheets if necessary) t Mml v pm lr fYDm f�,CiGG f D Q9yy�y�lihiu�►�i Estimated start date (month. day. year) q • 1 • ZOo '7 Estimated completion date (month, day, year) q ' 1 • ZODS SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED -. 777mber Salaries Number retained Salaries Number additional Salaries SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT NOTE: Pursuant to IC 6- 1.1- 12.1 -5.1 (d) (2) the COST of the property REAL ESTATE IMPROVEMENTS is confidential. COST ASSESSED VALUE Current values t, 3 � Plus estimated values of proposed project 1 DDS 00c) ? Less values of any property being replaced =Net values upon completion of project -a /QO 00 3Q SECTION • AND OTHER BENEFITS PROMISED Estimated solid waste converted (pounds) Estimated hazardous waste converte Other benefits rice i 007 ECrr:l`ID, E IN SECTION • I hereb rtify Whe representations in this statement are true. Signature of at ri representative Title Date signed (month, day, year) Page 1 of 2' �o �S 3