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Filed in Clerk's Office <br /> C4\/: <br /> STATEMENT OF BENEFITSMAR 2 5 201920PAY20REAL ESTATE IMPROVEMENTS <br /> Slate Form 617n7(R6! 0-94) i i t;_Jfir,,{ RFORM SB-1/Real Property <br /> Prescribed by the Department of Local Government Finan � E1=idiMt <br /> CITY(`.t F..9t.:,< SOUTH IT.1 PF 'D IN PRIVACY NOTICE <br /> This statement is being completed for real property that qualifies under the f <br /> CITY. Coda check ono tithe).—'——• My Information concerning the cost <br /> Q Redevelopment or rehabilitationt of real estate improvements(IC 6-1.1-12,1-4) of thepre xny and splits nby Inn <br /> pard to individual employees by tion <br /> ❑Residentially distressed area(IC 6-1.1-12,1-4.1) pproperty owner is confidential oar <br /> INSTRUCTIONS: IC 6.1.1-121-5.1. <br /> 1. This statement must be submrlfed 10 the body designating the Economic Revitalization Aloa prior to the public hearing if the designating body requires <br /> InlomatIon from the applicant in making its decision about whether to designate.en Economic Revitalization Arse. Otherwise,this statement must he <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 on economic revllalizatlon area before the inglel/on of <br /> the re.develepmenf 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 IO In the year in which the addition to assessed valuation Is <br /> made or not later than thirty(30)days oiler the assessment notice Is mailed/o the properly owner if It was malted after Apra 10. A properly owner who <br /> failed fo file a deduction application within the prescribed deadline may lila an application between March 1 and May 10 of a subsequent yeah <br /> 4I. A property owner who files for the deduction must provide the County Auditor end designating body with a Form CF-1/Reel Property. The Form CF-1/Real <br /> Properly 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 6-1.1-12.1-5.1(b) <br /> 5. For a Form SB-I/Real Property that is approved atter June 30, 2013, the designating body is required to establish an abatement schedule for each <br /> deduction slowed. For a Form SB-1/Real Property that is approved prior fo 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 /> CBK Land Development, LLC <br /> Address et taxpayer(number and street.city stats.and ZIP code) — <br /> 5245 Dylan Drive South Bend, IN 46628 <br /> Name of contact person Telephone number E-moll address <br /> ( ) 248-620-7784 landrew@chaseplastics.com <br /> SECTION 2 LOCATION AND'DESCRIPTION OF PROPOSED PROJECT <br /> Name of designating body Resclutlon number <br /> CBK Land Development, LLC <br /> Location or propertyCounty DLGF taxing district number <br /> 5245 Dylan Drive, South Bend, IN 466281 St. Joseph <br /> Description of real property unprovements,redevelopment,or rehabilitation(use addeonel sheets If necessary) EnUmnled start data(month,day,year) <br /> May 2019 <br /> Project will consist of adding an approximate 80,000 sq.ft. to the existing 126,000 sq. ft.at Estimated completion dela(moMr,day,year) <br /> January 2020 <br /> SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT <br /> Currant number Salaries Number retained Salaries Number additional Salaries <br /> 18 $847,000 18 $847,000 13 $520,000 <br /> SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT I <br /> REAL ESTATE IMPROVEMENTS ! <br /> COST ASSESSED VALUE <br /> Current values $5,647,964 $3,465,000 <br /> Plus estimated values of proposed project !$3,500,000 I <br /> l Less values of any properly being replaced Is() l 1 <br /> Net estimated values upon comr!ellon of•rolect $9,147,964 <br /> SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER <br /> Estimated solid waste converted(pounds) Estimated hazardous waste conversed(pounds) 1 • <br /> Other benefits l <br /> I <br /> 1 <br /> SECTION G TAXPAYER CERTIFICATION <br /> I heroby certify that the representations in this statement are true. <br /> Sigtiro of authorize cental Delo shred(month.day.year) <br /> 1 .V /f 9 <br /> Printed name of authorized represental a Titin <br /> ���Efz'r- t t�cc4 <br /> t„C s,fuss-�&.S < <br /> Page 1 of2 <br />