20-34 Designating Real Property Tax Abatment for Tri-Pac, Inc

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FIIPri ir. r• _ ; rel' ice STATEMENT OF BENEFITS SEP l 1620 PERSONAL PROPERTY State Form 51764 (R4111-15) OAWN M. J NE! Prescribed by the Depadmenl off- mal Government FinaICITY CLERK, SOUTH B FORM SB -1 I PP A" "farms ban concerning the cent o1 the p bm I; specific srtaritw paid to maia,doel umployads by the properly IAFSTRUC77ONS owner is wNidenaal per IC &I 1-12. Fa 1 1 This statement must be submitted to the body designating the EcOrmmlc Revitalization Area prior to the public hearing i/ the designating body requires mtomnatign nom the applicant In making its decision about whether to desgnale an Econivid: Revitalization Area. Ofherwise this statement must be submitted lo the designating Will, BEFORE a person installs the nem maindWi sing equipment andAzr rosaaren and development equipment, and/or logistical is fabuthon equipment andlor information leehn0409Y 094et mem for which the person wishes to dam a deduction. 2. The statement of benefits form must be submitted to the designating body and the area designated do economic revitelizafion area before the installation olqua/dying abatable equipment for which the person desires m c/amr, a deduction 3. To obtain a deduction, a person must file a certified deduction schedule with the person's personal property reliant an a certified deduction schedule (Form 103 -ERA) with the mHanshlb assessor of the township where the property is satiated or with the county assessor;/than, is no township assessor for the township, The 103 -ERA must be. filed between January 1 and May 75 of the assessment year in which new manutectudng equipment andrbr research and development equipment anWa logistical distribution equipment andror information tachnolegy equipment !s Installed and fullyPorwYionab unless a aGrg extension has been obtained. A person who obtains a hang extension must life the tom between Jarwary i and the exlrnded due date of that year 4. PrOtiOny owners whose Statement of Benefit; was approved, must submit Form CF f/PP annually to show compliance with the Statement of Benefits. (IC 5 Fora Form SS- 1/PPthat is eopmved after June 30. 2013, the designafirg body is required to establish an abatement schedule for each deduction allowed Fora Form SS-uPP that is approved priorto July 1. 2013, the abatement schedule approved by the designating body remains in effect (ICS -1.1421-17) Inc. mmacl person nShhP Address or taxpayer (number and sl reef, city, stale, and ZIP CMe) o a resident 3333 N Kenmore St, South Bend, IN 46628 Teiepbom number SECTION ( 574 )855 2187 2 LOCATION D DESCRIPTION Name of designating body 71 awasillatil South Bend City Council Rewlulipm nurMer (s) Lo Mon MpropeM 4303 Technology Drive, South Bend, IN 46628 County DLGF taxing dkirlot number ST JOSEPH 009 Dasctiptimi Of manufacturing equipment a,dill research and deve:opmen: equipment and/or 10099lslical distribution equipment andfor information techiiotogy agwp (Use addrbVnalsheetellnecressary.) re ESTIMATED START DATE COMPLETION DATE Manufacturing Equipment 9/15/2020 12/31/2021 New Pharma/PPE equipment purchases- R&D R d D Equipment Dist Equipment IT Equipment Current number Salaries Nvmbenetained 0 Sala:,cc Numper,ddNonal Salaries 0 0 0 20 746 0000 NOTE: Pursuant to IC 6-1.1-12.1-5.1 (d) (2) the MANUFACTURING E NPM R & D EQUIPMENT LOGISTOIST IT EQUIPMENT COST of the properly is confidential' COST ASSESSED IF, COST ASSESSED ASSESSB AS COST VALUE Current values VALUE VALDE COST ALSSED LIE Plus estimated values of proposed pro eel 20000 600000 Less values of any property being r Isced Net estimated values upon Completion of pro ect 2000000 Annonn ' •AJ Estimated solid waste convened (pounds)Estimated hazardous waste converted (pounds) 00er benefits: — SECTION 6 1 Hereby cemty that the represemat(ons in this stalel are true, s Signaturectaul - ed rc nesmd Date signed (month, day, year) August 26, 2020 Primed name of eathorized representativeTitle Vikram Shah President Page 1 of 2