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~t"~~`"'F~ STATEMENT OF BENEFITS <br />~~ ~ REAL ESTATE IMPROVEMENTS <br />~, ^ ,. -' State Form 51767 (R2l 1-07) <br />'' 6~~' 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 />^ Redevelopment or rehabilitation of real estate improvements (IC 6-1.1-12.1-4) <br />^ Eligible vacant building (IC 6-1.1-12.1-4.8) <br />20` PAY 20-____ <br />FORM SB-1 /Real Property <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 the redevelopment or rehabilitation of real property for which the person wishes to claim a deduction. <br />"Projects" planned or committed to after July 1, 1987, and areas designated after July 1, 1987, require a STATEMENT OF BENEFITS. (IC 6-1.1-12.1) <br />2. Approval of the designating body (City Council, Town Board, County Council, etc.) must be obtained prior fo initiation of the redevelopment or rehabilitation, <br />BEFORE a deduction maybe approved. <br />3. To obtain a deduction, application Form 322 ERA/RE or Form 322 ERANBD, Whichever is applicable, must be filed with the CountyAuditor by the later <br />of.• (1) May 1 D; or (2) thirty (30) days after the notice of addition to assessed valuation or new assessment is mailed to the property owner at the address <br />shown on the records of the township assessor. <br />4. Property owners whose Statement of Benefits was approved after June 30, 1991, must attach a Form CF-1/Real Property annually to the application to <br />show compliance with the Statement of Benefits. (IC 6-1.1-12.1-5.1(b) and IC 6-1.1-12.1-5.3(j)] <br />5. The schedules established under IC 6-1.1-12.1-4(d) for rehabilitated property and under IC 6-1.1-12.1-4.8(1) for vacant buildings apply to any statement <br />of benefits approved on or after July 1, 2000. The schedules effective prior to July 1, 2000, shall continue to apply to a statement of benefits filed before <br />Julv 1. 2000. <br />~ •- • <br />Name of taxpayer <br />Cooreman Real Estate Grou ,Inc. <br />Address of taxpayer (number and street, city, state, and ZIP code) <br />4404 Technolo Drive, South Bend iN 46628 <br />Name of contact person Telephone number E-mail address <br />Steve Cooreman 574.277.0116 steve@cooreman.com <br />-.•. ~ •-. <br />Name of designating body Resolution number <br />South Bend Common Council <br />Location of property County DLGF taxing district number <br />N of Brick Rd./E of Oran a Rd./W of US 31 B ass St. Jose h German Townshi <br />Description of real property improvements, redevelopment, or rehabilitation (use additional sheets if necessary) Estimated start date (month, day, year) <br />Four (4) homes in The Villas at Lake Blackthorn Section II - a single family home 05/01/2008 <br />subdivision which has a total of eight (8) lots located on 2.7+/- acres. Adjacent to Villas at Estimated completion date (month, day, year) <br />Lake Blackthorn Section I. Avg house price is $175,000. Avg lot price is $35,000. 05/31/2013 <br />-.•. ~ -. <br />Current number Salaries Number retained Salaries Number additional Salaries <br />N/A N/A ~ N/A N/A N/A N/A <br />-.•. ~ •-. <br />NOTE: Pursuant to IC 6-1.1-12.1-5.1 (d) (2) the COST of the property REAL ESTATE IMPROVEMENTS <br />is confidential. COST ASSESSED VALUE <br />Current values <br />Plus estimated values of proposed project <br />Less values of any property being replaced N/A <br />Net estimated values upon completion of project 4 0 840 00 <br />• • ~ ~ • •• ~ <br />Estimated solid waste converted (pounds) N/A Estimated hazardous waste converted (pounds) N/A <br />Other benefits bl~r~-t2 r~ ,pt~ [•~S~ }~~,is~' <br />~4d+ ~6Y c„F~~3 <br />N/A { i2:.: <br />APR 2 3 ~C~~3 <br /> <br />JO~it~ Vrf3FlJE . <br />IFt. <br />BEtdD <br />, <br />/ CI TY ~tr~t*, SQ. <br />I here a re sentations in this statement are true. <br />Signature f rized represe tive Title Date signed (month, day, year) <br />9 reSi ~ 23 200 <br />~' D - ~ Page 1 of 2 <br />