Laserfiche WebLink
4 STATEMENT OF BENEFITS 2o_ PAY 20 <br />�— REAL ESTATE IMPROVEMENTS <br />State Form 51767 (8211-07) FORM SB4 I Real Property <br />Prescribed by the Departrnent of Local Government Finance <br />This statement is being completed for real property that qualifies under the following Indiana Code (check one box): <br />❑ Redevelopment or rehabilitation of real estate improvements (IC 6-1.1- 12.1 -4) <br />❑ Eligible vacant building (IC 6-1.1- 12.14.8) <br />INSTRUCT IONS: <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, 1987, and areas designated after July 1, 1987, require a STATEMENT OF BENEFITS. (1C 6-1.1 -12.1) <br />2. Approval of the designating body (City Council, Town Board, County Council, etc.) be obtained prior to Initiation of the redevelopment or rehabilltation, <br />BEFORE a deduction may be approved. <br />3. To obtain a deduction, application Form 322 ERA/RE or Fort 322 ERA/VBD, Whicheve Is applicable, must be Bled 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 ew assessment is mailed to the property owner of (headdress <br />shown on the records of the township assessor. <br />4. Property owners whose Statement of Berleifjts was approved after June 30, 1991, must ttach a Form CF- 1/Real Property annually to the application to <br />show compliance with the Statement ofBp6efits. jiC 6-1.1- 12.1- 5.1(b) and iC 6-1.1 -12.1 .3(n) <br />5. The schedules established under IC6 -1 - 12.1- 4(d)for rehabilitated property and under 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 schedulas effective prior to July 1, 20 0, shall continue to apply to a statement of benerts filed before <br />.Ir,ry l 2nnn <br />Page 1 of 2 <br />SECTION •. <br />Name of taxpayer lj n <br />c 11C <br />`and <br />Address of taxpayer (number slme4 city, s and IPcode) <br />3 GA1 3 c7 <br />Name of contact person �-- r Tel rte number <br />E-mail address <br />SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT <br />Name R designating body <br />Resolution number <br />Location of property my <br />DLGF taxing district number <br />Description of real property improvements, redevelopment, or n: habilitation (use addition is if necessary) <br />Estimated start date (month, day, year) <br />Estimated completion date ( month, day, year) <br />SECTION 3 ESTIMATE OF EMPLOYEES AND SAIARIES AS RESULT OF PROPOSED PROJECT <br />Current number Salaries Number retained Salaries Number additional Salaries <br />SECTION 4 ESTIMATED TOTAL COSTAND VALUE OF PROPOSED PROJECT <br />NOTE: Pursuant to IC 6-1.1- 12.1.5.1 (d) (2) the COST of the prope REAL E ATE IMPROVEMENTS <br />Is confidential. COST ASSESSED VALUE <br />Current values <br />Plus estimated values of proposed project <br />Less values of any property being replaced <br />Net estimated values upon completion of project <br />SECTION • . AND OTHER BE14EFITS PROMISED <br />Estimated solid waste converted (pounds) <br />Estimated hazardous waste converted (poun <br />Other benefits <br />SECTION • <br />1 hereby certify that the representations In this statement are truef�o <br />Signature of authorized representative <br />Title <br />Dat)a signed (month, day, yea4. <br />Page 1 of 2 <br />