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i <br /> STATEMENT OF BENEFITS ` <br /> REAL ESTATE IMPROVEMENTS 20___ PAY 2o_ _ <br /> Stale Fani 511e1(R4 12.13) FORM 60-11 Real Property <br /> Prescribed by the Department of Local Government Finance <br /> PRIVACY NOTICE <br /> This statement Is being completed for real property that qualifies under the following Indiana Code(check one bo)c): 1pelr e cost and any specific indi✓,dual s <br /> ❑ Redevelopment or rehobilita(lon of real estate improvements(IC 6-1.1-12.10 a+encenoftnaiDng515 ubic rtco d <br /> D Resldenlialty dls(ressed area(IC 6 1.1-12.1-4.1) k e-1-1-f2.1-s.1ly and(d) <br /> INSTRUCTIONS: <br /> 1, This statement must be submitted to the body designating the Econanfk Rovltalizatton Area prlorlo the public hearing If the designating bodyraqulres <br /> information from the applicant In making its decision about whather to designate an Economic Revitalization Area. Olhenviso,(his 3fatement must be <br /> submitted to the designating body BEFORE the redevelopment or rehabMallon of real properly for tvhkil lire person lushes to claim a deduction. <br /> Prgacts'pianned or committed io aflerJuly 1, 1987,and areas designated aRerJuiy 1, 1987,requke a STATEMENT OF BENEFITS. (IC 6-1.1-121) <br /> 2 Approval of the designating body(City Council, Ymm Board,Counly Council,etc.)must be obtained priorto Inhiallon of the redevelopment or <br /> rehabllitallon,BEFORE deduction may be approved. <br /> 3. To obtain a deduction,a Form 322rRE must be filed with the CounfyAuddor before May 10 in the yearin which the addition to assessed valwWon is <br /> made or not later than thirty(30)days afterlhe assessment notice Is mallad to the property ownerif divas mailed aRerApril 10. If Iha property owner <br /> misses the May 10 deaddav in the inillal year of occupation,he can apply between March 1 and May 10 of s subsequent year, <br /> 4- Property owners whose Statement of BeneRr s was approved aher June 30, 1991,must attach a Form CF-1/Real Property snnuetty to the application to <br /> show cornplianco with the Statement of Benefits. (iC 6.1.1.12.1-5.l(b)and IC 61.1.12.1.5, <br /> 5. The schedules eslobahad under IC G 1.1-12,1-4(d)for rohablGletedproperty app y to any economic revitalization areas designated afferJUne 30,2000, <br /> unless an ahemattve dedvoNon Schedule is adopted by the designating body(iC 6-1.1-12,1-17). The schedules eNecilve priorto July 1,2000,shall <br /> continue to apply to economic revilalhetion areas designated before July 1,2000. <br /> WRIMI • <br /> Nnme of taxpayer <br /> The Toner at Wsringtm Squar•t LC <br /> Add re"of laxpayar(nvnl6or end s1maI,dryV00 endZ!Pcode) <br /> 614 477th Avcnua.3rd Flocr,Long Rand C7•NY 11101 <br /> NamG of conbsct pars" X;cphono number E•mai:eddroes <br /> Liberty Angneedes �1&7665 55 thelateraP,vash'rv0lonsq�er•IiY�gmei.00rn <br /> Name of des(pnallny body RcWutbn number <br /> South Bond Common Comdl 415 <br /> Lout eon of prcgersy County DLGf IafdAg di•Ircl number <br /> 211 W.WasrinplotlSt. w st,loseph _ <br /> 6 cnption sweat properly Irrprovemen .redevetop=n rehabliur5on(use lfnecessary) Esbmaled 4wt dale(mh th,day, <br /> 091'10/15 <br /> 1ho W,4,D-s eyo and zgnifK t deferred mn nlcnnnro Issues ha•ro madn Iha wtding obso'es l%vu co a compla•.e rnod•mbation of brhVrq,Indu Ealane:ed txxnplttial de;e(month,dry,yeai) <br /> - olrovn <br /> currenlnumbcr Spledes Nurrbenelatncd Set•rles NumteraddifoneJ Salaries <br /> 0 0 1 12x0 <br /> • r r • r . •-. r ••t <br /> REAL ESTATE IMPROVEMENTS <br /> COST ASSESSED VALUE <br /> Current values _-. ------- /1 9-s 1/1 9/Ll <br /> Plus e-silmeted values of proposed project _ 2239000 <br /> Lass values of arty property being replaced <br /> Net astlinaled values upon oompleUon of pro ecl <br /> E61101ated solid waste converted(pounds) Estimated Racardous waste converted(pounds) <br /> Olhor bvrlcfil+ _- <br /> SECTION • <br /> 1 hereby certify that the representations in this statement are true. <br /> Signs r ofavV;crized«pres•n❑ Tite Dateslgnad(monlh,dey.yea>1 <br /> ha�sg rr &'Ia/15 <br /> Page 1 of 2 <br />