19-31 31 Nimtz Land Confirming Real Property Tax Abatement

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Filed in Clerk's Office STATEMENT OF BENEFITS 20 PAY 20 REAL ESTATE IMPROVEMENTS 1 APR 01 2019 State Form 51767(R6 r 10-14) I FORM SB-1/Real Property Prescribed by the Department of Local Government Finance —' • KAnEEKiTtl'i FOWLER PRIVACY NOTICE This statement is being completed for real property that qualifies under ltie(gibpv(Ir(Q Irprpth (jop¢-(g1190¢r.114)1 Any Information concerning the cost Redevelopment or rehabilitation of real estate Improvementsor the properly and specific salaries ❑ P (IC 6 :1-12.1 4) • — paid to individual empbyees by the ❑Residentially distressed area(IC 6-1.1-12.1.4.1) property owner is confidential per Ic 6-1.1-12.1.5.1. INSTRUCTIONS: 1. This statement must be submitted to the body designating the Economic Revitalization Area prior to the public hearing if the designating body requires information from the applicant in making its decision about whether to designate an Economic Revitalization Area. Otherwise,this statement must be submitted to the designating body BEFORE the redevelopment or rehabilitation of real property for which the person wishes to claim a deduction. 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 the redevelopment or rehabilitation for which the person desires to claim a deduction. 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 made or not later than thirty(30)days alter the assessment notice is mailed to the property owner If It was mailed after April 10. A property owner who failed to file a deduction application within the prescribed deadline may file an application between March 1 and May 10 of a subsequent year, 4. A property owner who files for the deduction must provide the County Auditor and designating body with a Form CF-1/Real Properly The Form CF-1/Real Properly shock!be attached to the Form 322/RE when the deduction is first claimed and then updated annually for each year the deduction is applicable. IC 6-1.1-12.1-5.1(b) 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 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 remains In effect. IC 6-1.1-12.1-17 SECTION 1 TAXPAYER INFORMATION Name of taxpayer 31 Nimtz Land LLC Address of taxpayer(number and street,city stale,end ZiP code) 227 S. Main Street,Ste. 300, South Bend, IN 46601 Name of contact person Telephone number E-mail address au ( ) 574-217-4498 pphair@holladaypraperties.j SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT Norma of doslgnaing body Resolution number City of South Bend Location of property I County DLOF taxing district number 24605 Cleveland Road,South Bend, IN St.Joseph Description of real property improvements.redevelopment,or rehabilitation(use addbonef shoats if necessary) Estimated start date(month,day,year) July 1,2019 The proposed project is an approximately 225,000 square foot industrial facility to be locate Estimated completion date(month,day,year) March 31,2020 SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT Current number Salaries Number retained Salaries Number additional Salaries Unknown SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT REAL ESTATE IMPROVEMENTS COST ASSESSED VALUE Current values 1$208,400 Plus estimated values of proposed project $12,940,000 I Less values of any property being replaced I$0 Net estimated values upon completion of pro, c1 12,940.000 SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER Estimated solid waste converted(pounds) Estimated hazardous waste converted(pounds) Other benefits SECTION 6 TAXPAYER CERTIFICATION I hereby certify that the representations In this statement are true. Slgnat a of authorize rosontative Date signed(mond.dirt year) PunerinCed name of authorized representative Tile 1I Pa.r 1 1714,.4.--- f'ir. tl e / Page 1 of 2