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Auo I s 2020 <br />/ £" \ STATEMENT OF BENEFITS <br />,,, REAL ESTATE IMPROVEMENTS DAWN M, J NE <br />State Form 51767 (R61 10-14) Cm CLERK, SOUTH BEND, IN <br />1- Prescribed by the Department of Local Government Finance <br />This statement is being completed for real property that qualifies under the following Indiana Code (check one box) <br />- <br />m Redevelopment or rehabilitation of real estate improvements (IC 6-1.1-12.1 4) <br />m Residentially distressed area (IC 6-1.1-12.1-4.1) <br />20_ PAY 20_ <br />FORM SB -1 I Real Property <br />PRIVACY NOTICE <br />Any information concerning the cost <br />of the property and specific salaries <br />paid to individual employees by the <br />property owner is confidential per <br />IC 6-1 1-12.1-5'. <br />INSTRUCTIONS: <br />1. This statement must be submitted to the body designating the Economic Revitalization Area pnorto 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 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 an economic revitalization area before the initiation of <br />the redevelopment or rehabilitation for which the person desires to claim a deduction. <br />3. To obtain a deduction, a Form 3221RE must be filed with the County Auditor before May 10 in the year m which the addition to assessed valuation is <br />made or not later than thirty (30) days after the assessment notice is mailed to the property owner if it was mailed alter April 10. A property owner who <br />failed to file a deduction application within the prescribed deadline may file an application between March 1 and May 10 of a subsequent year <br />4. Aproperty owner who files for the deduction must provide the County Auditor and designating body with a Form CF-1/Real Property The Fofm CF-IlReal <br />Property should be attached to the Form 3221RE 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-llReal Property that is approved after June 3Q 2013, the designating body is required to establish an abatement schedule for each <br />deduction allowed For a Form S13-1rReal Property that is approved prior to July 1, 2013, the abatement schedule approved by the designating body <br />remains in effect. IC 6-1.1-12.1-17 <br />SECTIONINFORMATION <br />Name of taxpayer <br />South Bend Mutual Homes II, LP <br />Address of taxpayer (number and street city state, and ZIP code) <br />724 W. Washington St., South Bend, IN 46601 <br />Name of contact personTelephone <br />number <br />T(e7 <br />E-mail address <br />Anne Mannix <br />2884369 <br />amannix. nd aii mail. com <br />SECTION 2 LOCATION AND DESCRIPTION <br />OF PROPOSED PROJECT <br />Name of designating body <br />Resolution number <br />City of South Bend <br />4725-18 <br />Location of property <br />County <br />DLGF taxing district number <br />See attached list <br />St. Joseph <br />026-0011 <br />Description of real property improvements, redevelopment, or rehablitalion (use additional <br />sheets if necessary) <br />Estimated start date (month, day year) <br />Fourteen newly constructed homes. <br />April 1,2021 <br />Estimated completion date (month, day year) <br />April 1, 2022 <br />SECTION 3 ESTIMATE OF EMPLOYEESAND SALARIESAS <br />RESULTOF PROPOSED PROJECT <br />Cu.m n; number Salaries Number retained <br />Salaries Number additional Salaries <br />1.00 $40,000.00 1.00 <br />$40,000.00 0.50 $20,000.00 <br />SECTION 4 ESTIMATED TOTAL COST AND <br />VALUE OF PROPOSED PROJECT <br />REAL ESTATE IMPROVEMENTS <br />COST ASSESSED VALUE <br />Current values <br />0.00 27.600 00 <br />Plus estimated values of proposed project <br />3,03240000 583,33800 <br />Less values of any property being replaced <br />000 a W <br />Net estimated values apon completion of project <br />3,032400.00 5to,g38 o0 <br />SECTION 5 WASTE CONVERTEDAND OTHER <br />BENEFITS PROMISED BY THE TAXPAYER <br />Estimated solid waste converted (pounds) -m0.00 _ <br />Estimated hazardous waste converted (pounds) 0. 00 <br />Other benefits <br />1) Revitalization of the Northwest neighborhood. 2) Provision of fourteen <br />units of affordable housing. 3) About 38 short term <br />construction jobs for a one year period. <br />SECTION. <br />I hereby certify that the representations in this statement are true. <br />Signature of authorized representative //pp 7 <br />tom.+ — // 11-41 <br />Date signed (month, day read <br />(3-11 <br />Printed name of authonzed representative <br />K ri vi- L- li nn tk- <br />Title <br />Met kLor kl �WC-lo dl <br />Pagel of Avocx-.- f C.LG7 ( evut6Xr <br />