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Filed in Clerk's Office <br /> STATEMENT OF BENEFITS —� 2020 PAY 2021 <br /> o°,+t.'-'. i REAL ESTATE IMPROVEMENTS ' MAR 2 9 2019 <br /> si I <br /> State Form 51767(R6/10-14) I FORM SB-1 1 Real Property f <br /> �, ' <br /> ,,."' Prescribed by the Department of Local Government Finance <br /> {(p aN (� PRIVACY NOTICE <br /> This statement is being completed for real property that qualifies under ttje Ir t �COt �{Cti�bax): Any information concerning the cost <br /> Wedevelopment or rehabilitation of real estate improvements(IC 6-1.17_ 1_4 K,SOIJTI-1 BEND, IN of the property and specific salaries <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 I <br /> INSTRUCTIONS: <br /> iC 6-1.1-12.1-5.1. <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 /> 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 deduction,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 owner 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 should 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 6-1.1-12.1-51(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 allowed. 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 effect. IC 6-1.1-12.1-17 <br /> SECTION 1 TAXPAYER INFORMATION <br /> Name of taxpayer • <br /> GLC Portage Prairie IV <br /> Address of taxpayer(number and street,city,state,and ZiP code) <br /> 112 W Jefferson Suite 200 <br /> Name of contact person Telephone number E-mail address <br /> Jcff Smoke,Director of Development ( ) 574-855-5700 jsmoke@greatlakescapital.co <br /> SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT <br /> Name of designating body Resolution number I <br /> Common Council of City of South Bend <br /> Location of properlyCounty DLGF taxing district number } <br /> NE Corner of Adams Road and U.S.31 Bylass I St.Joseph (ff <br /> Description of real property improvements,redevelopment,or rehabilitation(use addtional sheets if necessary) Estimated start date(month,day,year) t <br /> July 15 2019 <br /> Proposed investment of over$7,000,000 in the construction of a-166,000 square foot facility Estimated completion date(month,day,year) <br /> January 2021 i <br /> SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT I <br /> Current number Salaries Number retained Salaries Number additional Salaries <br /> SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT <br /> REAL ESTATE IMPROVEMENTS <br /> I COST I ASSESSED VALUE <br /> I Current values 1270,000 <br /> Plus estimated values of proposed project 17,200.000 I <br /> Less values of any property being replaced I i <br /> Net estimated values u.on com.letion of pro'ect <br /> SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER <br /> Estimated solid waste converted(pounds) Estimated hazardous waste converted(pounds) I <br /> Other benefits <br /> I <br /> 1 <br /> { <br /> SECTION 6 TAXPAYER CERTIFICATION <br /> I hereby certify that the representati ns in this s tement are true. <br /> Signature of authorized representativeV jq�(month,1 day,year) I <br /> Date <br /> Printed name of authorized representativ f Title <br /> sets .Sr`A4\1L. I Q rcA, 1 <br /> Page 1 of 2 <br /> I <br /> i <br />