03-24-08 Council Meeting Agenda & Packet

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~ °r~ra SN " ~ ~ a~ ~~. STATEMENT OF BENEFITS -~~a; PERSONAL PROPERTY .r ~~ State Form 51764 (R / 1-06) '°'• Prescribed by the Department of Local Government Finance INSTRUCTIONS u ..a,.......... -- .... -_ .-<- ..-,y _....., _ -.n._1._.. .. -.s -~ PRIVACY NOTICE The ost and any specific individual's sala information is confidential; the bala ce of the filing is public record per 6-1.1-12.1-5.1 (c) and (d). 1. This statement must be submitted to the body designating fhe Economic Revit~ti~~+%^^ a~d~r~i~t+r~i~•r~ti~lfb lf~arino if file 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 a person installs the new manufacturing equipment and/or research and development equipment, and/or logistical distribution equipment and/or information technology equipment for which the person wishes to claim a deduction. "Projects" planned or committed to after July 1, 1987, and areas designated aRer July 1, 1987, require a STATEMENT OF BENEFITS. (IC 6-1.1-12.1) 2. Approval of the designating body (City Council, Town Board, County Council, etc.) must be obtained prior to installation of the new manufacturing equipment and/or research and development equipment and/or logistical distribution equipment and/or information technology equipment, BEFORE a deduction may be approved 3. To obtain a deduction, a person must file a certified deduction schedule with the person's personal property return on a certified deduction schedule (Form 103-ERA) with the township assessor of the township where the property is situated. The 103-ERA must be filed between March 1 and May 15 of the assessment year in which new manufacturing equipment and/or research and development equipment and/or logistical distribution equipment and/or information technology equipment ~ installed and fully functional, unless a filing extension has been obtained. A person who obtains a filing extension must file the form between March 1 and the extended due date of that year. 4. Property owners whose Statement of Benefits was approved after June 30, 1991, must submit Form CF-1 / PP annually to show compliance with the Statement ofBenefrts. (IC6-1.1-12.f-5.6) 5. The schedules established underlC 6-1.1-12.1-4.5(d) and (e) apply to equipment installed aRer March 1,. 2001. For equipment installed prior to March 2, ~nnf tha crherlules and statutes in effect at the time shall continue to apply. (IC 6-1.1-12.1-4.5(1) and (g)) •- • ~ Name of taxpayer •~ ~~~ r~1 ~l ~~ ~ ~ ~ ~ G~ I ~~ / ~ ~ reet, city, state, and ZIP code) t Address of taxpayer (number and s \^ , / ! .._~ ~ ~ ~ V ~ ^T ~I fit. / ~ ' ~ S y ~ 1 ~ J Name of contact person Telephone number ~~~-~ ~G_~/ES Name of designating body -r-~ i „ _ , ! ~ G1_' I * , ~ ~i rr~cT L-~ 1~1 r I V ~'~ ~ • Resolution number (s) Location of grope County DLGF taxing district number Ac ~T~~ ~vT~~ T Description of manufacturing equipment and/or research and development equipment ESTIMATED and/or logistical distribution equipment and/or information technology equipment. START DATE COMPLETION DATE (use additional sh4e~ts if nFece/s~sa~ry){ lA i (' Q ~i 5 V ~'~ I l~ f"t L' ~'~I ~ ~ I ~ ~~~ l~~:n"~i )'" VV Manufacturing Equipment ,`Z _ ~,5 . G~ 3 _ ~ ~_ ~~ - ~ R & D Equipment Logist Dist Equipment IT Equipment Current number Salaries Number retained Salaries Number additional Salaries MANUFACTURING NOTE: Pursuant to IC 6-1.1-12.1-5.1 (d) (2j the EQUIPMENT R 8 D EQUIPMENT LOGIST DIST IT EQUIPMENT EQUIPMENT COST of the property is confidential. COST ASSESSED VALUE COST ASSESSED COST ASSESSED COST ASSESSED VALUE VALUE VALUE Current values Plus estimated values of proposed project ~ Less values of any property being replaced f/ Net estimated values upon completion of project ~ s~ ~ • ~ ~ • '~ ~ Estimated solid waste converted (pounds) Estimated hazardous waste converted (pounds) Other benefits: ~ f I hereby certify that the representations in this statement are true. ' Signature of authorized representative ) Title ~ ~/ Date signed (month, /d-day, (year)