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70?'r'y a.. STATEMENT OF BENEFITS IL 1 2019 PAY 20 20 <br /> 1i,i REAL ESTATE IMPROVEMENTS JAN 8{/ state Form 51767(R6/10-14) FORM SB-1 I Real Property <br /> •' / Prescribed by the Department of Local Government Finan "-'- PRIVACY NOTICE <br /> ;pp�pb�Ef�4Ar - 1fLER <br /> This statement t being completed for real property that qualifies under the IIQwjpg�(tgi0(p;C;o �CheC Any information concerning the cost <br /> Qi Redevelopment or rehabilitation of real estate improvements(IC 6-1.1-1 '&4)J (G�IL.t�tiiKKKK .7. <br /> - UCiV[l,IN of the progeny and speulic eateries <br /> Paid to Individual employees by the <br /> 0 Residentially distressed area(IC 6-1.1-12.1-4.1) property owner is confidential per <br /> IC 6-1.1-12.1-5.1. <br /> iNSTRUCTIONo. <br /> 1, This stateme nt 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 /> 2. The statement of benefits form must be submitted to the designating body and the area designated an economic revitalization area before the Initiation of <br /> the redevelopment or rehabilitation for which the person desires to claim a deduction. <br /> 3. To obtain a Seduction.a Form 322/RE must be filed with the County Auditor before May 10 in the year in which the addition to assessed valuation is <br /> 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 <br /> failed to file a deduction application within the prescribed deadline may file an application between March 1 and May 10 of a subsequent year. <br /> 4. A property o aner who files for the deduction must provide the County Auditor and designating body with a Form CF-1/Real Property. The Form CF-1/Real <br /> Property shCuld be attached to the Form 322/RE when the deduction is first claimed and then updated annually for each year the deduction is applicable. <br /> iC 6-1.1-12. -5.1(b) <br /> 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 <br /> deduction alowed. For a Form SB-1/Real Property that is approved prior to July 1, 2013, the abatement schedule approved by the designating body <br /> remains in elect. IC 6-1.1-12.1-17 <br /> SECTION 1 TAXPAYER INFORMATION <br /> Name of texpeye (y44.5 a^✓ !- 5 ` A — <br /> Grace Steel LLC (Pam Andre is Woman Owrier) 4....e <br /> Address of taxptr er(number end street,city,state,and ZIP code) <br /> 21601 Du-ham Way, Bristol, IN 46507 <br /> Name of contact Gerson Telephone number E-mail address <br /> David An ire, Owner ( 574 ) 536-2445 davtdandre@gracesteeiselvice.com <br /> SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT <br /> Name of designs ng body Resolution number <br /> City Coun.il of South Bend <br /> Location of prope ty I County DLGF taxing district number <br /> 2920 Wes' Sample Street, South Bend, IN 46619 ST JOSEPH 026 <br /> Description of re. property,mprovoments.redevelopment or rehabilitation(use additional sheets if necessary) Estimated start date(month,day,year) <br /> Building purcease price of$765,000 with planned$500,000 building upgrades to operate manufacturing/distribution 2/15/2019 <br /> facility including modem roof,flooring,and loading docks.Legal description Is 400'On Sample Beg 330'E&35'S Estimated completion date(month,day.year) <br /> NW Cor NW pec 15-37-2e. Parcel number Is 018-8075-282401/018.8075-282404. 12/31/2020 <br /> SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT <br /> Current number Salaries Number retained Salaries Number additional Salaries <br /> 0.00 $0.00 0.00 $0.00 10.00 $416,000.00 <br /> SECTION 4 ESTIMATED TOTAL COS r AND VALUE OF PROPOSED PROJECT <br /> REAL ESTATE IMPROVEMENTS <br /> COST ASSESSED VALUE <br /> Current values <br /> Plus estimai cd values of proposed project 500,000.00 500.000.60 <br /> Less values if any property being replaced <br /> Net estimat-• values upon completion of proect 500.000.00 500,000.00 <br /> SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER <br /> Estimated s5 lid waste converted(pounds) Estimated hazardous waste converted(pounds) <br /> Other benefits <br /> . SECTION 6 TAXPAYER CERTIFICATION <br /> I hereby Certify that the repr•sen ons i IS statement are true. <br /> Signature of aid/timed repres¢hte' - Date signed(month,day,year) <br /> ,d li January 4, 2019 <br /> Pnnted name of I uthon representative 1 Title <br /> David Andre Owner <br /> Page 1 of 2 <br />