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STATEMENT OF BENEFITS
<br /> REAL ESTATE IMPROVEMENTS I 20 12 PAY 20 13
<br /> !' State Form 51767(8211.07) FORM S13-1 f Real Property
<br /> Prescribed by the Department of Local Government Finance
<br /> This statement is being completed For real property that qualifies Under the following Indiana Code(check one box):
<br /> 0 Redevelopment or rehabilitation of real estate improvements fIC 6-1.1-12.1-4)
<br /> 0 Eligible vacant building(IC 6-1.1-12.1-4.8)
<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
<br /> submitted to the designating body BEFORE the redevelopment or rehabilitation of real property for which the person wishes to claim a deduction.
<br /> "Projects"planned or committed to after July 1, 1967,and areas designated after July 1, 1987,require a STATEMENT OF BENEFITS.
<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 /> BEFORE a deduction maybe approved.
<br /> 3. To obtain a deduction,application Farm 322 ERA/RE or Form 322 ERAIVBD, Whichever is applicable,must be filed with the County Auditor by the later
<br /> 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
<br /> shown on the records of the township assessor.
<br /> 4, Property owners whose Statement of Benetlts was approved after June 30, 1991,must attach a Form CF-7/Real Property annually to the application to
<br /> show compliance with the Statement of Benefits. [IC B-i.1-12.1-5.1(b)and fC 6-1,142.1-S30)]
<br /> 5. The schedules established under 10 6-1.1-12.1-4 fd)for rehabilitated property and under 1C 6.1.1-12.1-4.8(1)for vacant buildings apply to any statement
<br /> of benefits approved on or after July 1,2000. The schedules effective prior to Jufy 1,2000,shall continue to apply to a statement of benefits filed before
<br /> July 1,2000.
<br /> • s •
<br /> Name of taxpayer
<br /> GVW REALTY, LLC
<br /> Address of taxpayer(number and street,city,state,and ZIP code)
<br /> 116 W. Jackson Street, Monroe, Indiana 46772
<br /> Name of contact person Telephone number E-mail address
<br /> Larry D.ZurCher (260)692-1416
<br /> la rryz(cDbestonetire,net
<br /> Name of designating body Resolution number
<br /> Common Council of City of South Bend
<br /> Location of property County DLGF lazing district number
<br /> 4411 Quality Drive, South Bend, Indiana St.Joseph 71-003
<br /> DescripWn of real property improvements,redevelopment,or rehabi[italion(use additional sheets if necessary) Estimated start date(month,day,year)
<br /> Contruction of new building addition of approxmiately 30,635 square feet 08/15/2011
<br /> Fstimated completion date(month,day,year)
<br /> 08/15/2012
<br /> Current number Salaries Number retained Salaries Number additional Salaries
<br /> 16+ $450,000+
<br /> • • • • • • -r•s • •-•
<br /> NOTE:Pursuant to IC 6-1.1-12.1-5,1 (d)(2)the COST of the property REAL ESTATE IMPROVEMENTS
<br /> is confidential. COST' ASSESSED VALUE
<br /> Current values 1 308.931.00 1,380,800.00
<br /> Plus estimated values of proposed project 1,500,000.00 Del.tinder Reg.17
<br /> Less values of any property being replaced
<br /> 0.00 0.00
<br /> Net estimated values upon completion of project 2,808,931,00 Det.Under Reg.17
<br /> r • :131491M • • -• •
<br /> Estimated solid waste converted(pounds) Estimated hazarddUs waste-converted(pounds)
<br /> Other benefits _
<br /> JUN
<br /> • •
<br /> !hereby certify that the representations in this statement are true.
<br /> Signature of authorized representative Title Date signed(month,day,year)
<br /> Managing Member
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