11-12-12 Council Agenda & Packet

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STATEMENT OF BENEFITS FORM SB-1 1 PP a PERSONAL PROPERTY +� State Form 51764(R/1.06) Prescribed by the Department of Local Government Finance PRIVACY NOTICE The cost and any specific individual's salary information is confidential;the balance of the filing is public record INSTRUCTIONS: per IC 6-1.1-12.1-5.1(c)and(d). 1, 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. 'Projects'planned or committed to after July 1, 1967, and areas designated after July 1, 1987,require a STATEMENT OF BENEFITS. (1C 6-1.1-12.1) 2. Approval of the designating body(City Council, Town Board, County Council,etc.) must be obtained prior to installation of the new manufacturing equipment and/or research and development equipment and/or logistical distribution equipment and/or information technology equipment,BEFORE a deduction may be approved 3. To obtain a deduction, a person must rile 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. The 103-ERA must be filed between March 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 March 1 and the extended due date of that year. 4. Property owners whose Statement of Benefits was approved after June 30, 1991, must submit Form CF-1/PP annually to show compliance with the Statement of Benefits. (IC 6-1.1-12.1-5.6) 5. The schedules established under!C 6-1.1-12.1-4.5(d)and(e)apply to equipment installed after March 1,2001. For equipment installed prior to March 2, 2001,the schedules and statutes in effect at the time shall continue to apply, IC 6-1.1-1 - s � Name of taxpayer EW Marine Address of taxpayer(number and street,city,state,and ZIP code) i 66480 High Meadow Ct, Edwardsburg, M149112 LQT g z o lz Name of contact person .,- Y T elephone number Jack Welter 4w7�cI `�g4o"q,. r Name of designating body Resolution number(s) Elkhart Plastics, Inc Location of property Couniy DLGF taxing Mstricl number 3300 N. Kenmore St, South Bend, IN 46628 Description of manufacturing equipment and/or research and development equipment ESTIMATED and/or logistical distribution equipment and/or information technology equipment. (use additional sheets if necessary) START DATE COMPLETION DATE Rotational Molding Equipment, CNC trimming machine, test Manufacturing Equipment 1/1/2013 3/1/2013 equipment to serve a new customer. R a D Equipment n/a n/a Logist Dist Equipment IT Equipment � e � e -s-o e -• ( Current number Salaries Number retained Salaries Number additional Salaries � � 0 r r�4 L.CCZ. -TCJ � l� v'(*iO �J ��J cps • s w e a s -s•s a •-o 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 ASSESSED COST ASSESSED COST ASSESSED COST ASSESSED Kim VALUE VALUE VALUE VALUE Current values 11.2 1 i 10.0 fP10° (o Pius estimated values of proposed project 1 ci.00-4i_Z 10�W0 Less values of any property being replaced -- -. Net estimated values upon completion of project e s e ea -e RISE" Estimated solid waste converted(pounds) ®' Estimated hazardous waste converted(pounds) Other benefits: ,y I hereby certify that the representations in this statement are true. Signature of uth iz r pre n ti Title Date si ned(manthr day,year)