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-,""t4,,, STATEMENT OF BENEFITS [ FORM SB-1 I PI-;-1 <br /> iii . PERSONAL PROPERTY <br /> �'\ State Form 51764(R4l 1 1-15) <br /> - _.�f Prescribed by the Department of Local Government Finance PRIVACY NOTICE <br /> Ary inform_. _ ,.ty the 2051 <br /> or the propery arm :peat c salaries paid <br /> to individual employees by the property <br /> owner is confidential per IC 6-1 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 an Economic Revitalization 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 and 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 certified deduction schedule <br /> (Form 103-ERA)with the township assessor of the township where the property is situated or with the county assessor if there is no township assessor <br /> for the township. The 103-ERA must be filed between January 1 and May 15 of the assessment year in which new manufacturing equipment <br /> and/or research and development equipment and/or logistical distribution equipment and/or information technology equipment is installed and fully <br /> functional.unless a filing extension has been obtained. A person who obtains a filing extension must file the form 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/PP annually to show compliance with the Statement of Benefits. <br /> (IC 6-1.1-12.1-5.6) <br /> 5. For a Form SB-1/PP that is approved after June 30,2013,the designating body is required to establish an abatement schedule for each deduction allowed. <br /> Fora Form SB-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 /> SECTION 1 TAXPAYER INFORMATION <br /> Name of taxpayer Name of contact person <br /> Bamar Plastics, Inc. Tricia Blair <br /> Address of taxpayer(number and street,city state,and ZIP code) Telephone number <br /> 1702 Robinson St.South Bend, IN 46613 1 574 ) 234-4066 <br /> SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT <br /> Name of designating body Resolution number(s) <br /> South Bend Common Council <br /> Location of property County DLGF taxing district number <br /> 1702 Robinson St.South Bend,IN 46613 St.Joseph <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 /> Injection Molding Presses Material Grinders Manufacturing Equipment 04/01/2020 01/31/2022 <br /> Robots Computers R&D Equipment <br /> Conveyors Phone System <br /> Pickers IT Server Logist Dist Equipment <br /> ERP System CAD System IT Equipment <br /> A- •, i• -u <br /> SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT <br /> CJr-enl number 1SalariesI Number retained Salaries Number additional Solaces <br /> 14 1660,205 14 $680,205 1 $60,000 <br /> SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT <br /> NOTE:Pursuant lc IC 6-1.1-12.1-5.1(d)(2)the MANUFACTURING R&D EQUIPMENT LOGIST DIST IT EQUIPMENT <br /> EQUIPMENT EQUIPMENT <br /> COST of the property is confidential. COST ASSESSED COST ASSESSED i COST ASSESSED COST ASSESSED <br /> VALUE VALUE VALUE VALUE <br /> Current values 2,587,513 L 70,111 <br /> Plus estimated values of proposed project 432,104 E f 217,000 <br /> Less values of any property being replaced 148,000 13,000 • <br /> Net estimated values upon completion of project 2,871,617 274,111 <br /> SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER <br /> Estimated solid waste converted(pounds) _ I Estimated hazardous waste converted(pounds) <br /> Other benefits <br /> SECTION 6 TAXPAYER CERTIFICATION <br /> I hereby certify that the representations in this statement are true. <br /> Signature of authorized ren Wive - Date signed( nth.d year) <br /> 1Lr C.cr` �'� -tet yob 3dgo <br /> Printed name of authorized representativeTide <br /> Tricia Blair 1 Secretary <br /> Page 1 of 2 <br />