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Filed in Clerk's Office <br /> I � <br /> ?''''',•,-.:-A <br /> � 4,� STATEMENT OF BENEFITS i MAR 2 5 2019 FORM 58-1 /PP <br /> -A PERSONAL PROPERTY <br /> a,.•.y Stats Form 51764(R4111-15) r- - <br /> Prescribed by the Department of Local Government FIMnce ht'`'`r ' r ?`` �' PRIVACY NOTICE <br /> rlT'r CLERK,SOUTH BEND,i ' Any Information concerning the cost <br /> -- - • of the property and specific solaria.)paid <br /> to individual employees by the property <br /> owner Is Conildenital per IC:6-r.1-12.1.5.1. <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 en Economic Revitalrzotion Area. Otherwise this statement must be <br /> submitted to the designating body BEFORE a person installs the new manufacturing equipment and/or research and development equipment,and/or <br /> logistical distribution equipment and/or Information technology equipment for which the person wishes to claim a deduction. <br /> 2. The statement of benefits form must be submitted to the designating body end the area designated an economic revitalization area before the installation <br /> of qualifying abatable equipment for which the person desires to claim a deduction. <br /> 3. To obtain a deduction,a person must file a certified deduction schedule with the person's personal property return on a certdied deduction schedule <br /> (Form 103-ERA)with the township assessor of the township where the property Is situated or with the county assessor,them is no township assessor <br /> for the township. The 103-ERA must bo flied between January 1 and May 15 of the assessment year In which new manufacturiny equipment <br /> and/or research and development equipment and/or logistical distribution equipment and/or Information technology equipment/s installed end fully <br /> functional,unless a filing extension has been obtained. A person who obtains a filing extension must life the famr between January 1 and the extended <br /> due date of that year. <br /> 4. Property owners whose Statement of Benefits was approved,must submit Form CF-1/YP annually to show compliance with the Statement of Benefits, <br /> (IC 6.1.1-111-5.6) <br /> 5. For a Form SB-1/PP that is approved after Juno 30,2013,fhe Ueslgnairlg body Is required to establish an abatement schedule for each deduction ailowed <br /> Fora Form S8-1/PP that Is approved prior to July 1,2013,the abatement schedule approved by the designating body remains in effect. (IC 6-1.1-12.1-17) <br /> f SECTiON 1 TAXPAYER INFORMATION <br /> Name of taxpayer Nemo of cantectperaon ! <br /> Chase Plastic Services, Inc, Lacie Andrew <br /> Address cf taxpayer(number endstrae(cIN state,end ZIP ccdo) Telephone number <br /> 5245 Dylan Drive South Bend, IN 46628 248-630-7784 <br /> SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT <br /> Nome of designating body Resolution number(s) <br /> Chase Plastic Services, Inc. <br /> Location of property I County DLGF taxing district number <br /> 5245 Dylan Drive South Bend, IN 46628 St.Joseph County <br /> Description of manufacturing equipment and/or research and development equipment ESTIMATED <br /> and/or logistical distribution equipment and/or Information technology equipment. START DATE COMPLETION DATE <br /> (Use additional sheets it necessary) <br /> Manufacturtng Equipment <br /> R a D Equipment <br /> Racking, Forklifts, Computer technology and material handling equip LogtatDiet Equipment May 2019 March 2020 <br /> IT Equipment May 2019 March 202 <br /> SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT <br /> Currentcumber Seisms Number retained Salaries Number additional Satanic. <br /> 18 $847,000 18 3847,000 13 $520,000 <br /> SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT <br /> NOTE:Pursuant to IC 6-1.1-12,1-6.1(d)(2)the MANUFACTURINGR&D EQUIPMENT LOGIST DIST IT EQUIPMENT <br /> EQUIPMENT EQUIPMENT <br /> COST of the property Is confidential. COST ASSESSED COST ASSESSED COST ASSESSED COST ASSESSED <br /> VALUE VALUE VALUE VALUE <br /> Current values •• I, II <br /> Plus estimated values of proposed project $608;,0 t■ $9b,UUU <br /> Less values of any properly being replaced <br /> Net estimated Values upon completion of project I o maw <br /> SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER <br /> EstImatedsolld waste converted(pounds) Estimated hazardous waste converted(pounds) <br /> Other benefits: <br /> SECTION 6 TAXPAYER CERTIF!CATION <br /> I hereby certify That the representations in this statement am true. <br /> Slpnelyregaullar+zad r en 'vn-----� Date atgne4(month,dolt year) <br /> �. 31z. 9 <br /> print a of au zed repreaeen ve <br /> Y_`?)e- 1--k..1--r. I TM IRs rwL'� "fr6s i—te� C, <br /> Page 1of2 <br /> I <br />