05-11-20 Agenda Packet - Laserfiche WebLink

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STATEMENT OF BENEFITS q PERSONAL PROPERTY FORM SB-1 /PP 1"• 't , Slate Form 51764(R4!11-15) r Prescribed by the Department of Local Government Finance PRIVACY NOTICE Any Information concerning the cast of the property and specific salaries paid to individual employees by the property owner is confidential per IC e-1 1-12.1.5 1. INSTRUCTIONS 7. 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 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 2. The statement of benefits form must be submitted to the designating body and the area designated an economic revitalization area before the installation of qualifying abatable equipment for which the person desires to claim a deduction. 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 or with the county assessor If there is no township assessor for the township. The 103-ERA must be filed between January 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 is installed and fully 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 due date of that year. 4. Property owners whose Statement of Benefits was approved, must submit Form CF-I/PP annually to show compliance with the Statement of Benefits. IC 6-1.1-12.1-5.6) 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. 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) SECTION 1 TAXPAYER INFORMATION Name of taxpayer Name of contact person WSJM-INC Dave Doetsch Address of taxpayer(number and street,city slate,and ZIP code) Tatephone number 1301 East Douglas Road,Mishawaka, IN 46545 269-925-1111 SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT Name of designating body Resorul on number(s) City of South Bend Location of property County DLGF taxing district number 316 East Monroe Street St.Joseph County Description of manufacturing equipment and/or research and development equipment ESTIMATED and/or logistical distribution equipment and/or information technology equipment. START DATE COMPLETION DATEUseadditional sheets if necessary) Manufacturing Equipment R&D Equipment Logist Dist Equipment IT Equipment 12/7/20 2/12/21 SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT Current number Salaries Number retained Salaries Number additional Salaries 23 1,040,520 23 1,040,520 l S104,957 SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT NOTE Pursuant to IC 6-1.1-12.1-5.1(d)(2)the MANUFACTURING R&D EQUIPMENT LOGIST DIST IT EQUIPMENT EQUIPMENT EQUIPMENT COST of the property is confidential. COST COSTASSESSEDASSESSED ASSESSED ASSESSEDCOST VALUE VALUE VALUE COST VALUE Current values Plus estimated values of proposed project 50,000 SBCD,000 Less values of any property being replaced 0 Net estimated values upon completion of project r 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 ttys}statement are true. Si nature of authrxiz re - ntative /Dela signed(month,day.year) f April 8, 2020 Print name of authorized representafive I Title Dave Doetsch President Page 1 of 2