12-10-12 Council Agenda & Packet

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■ 4?a STATEMENT OF BENEFITS FORM SB-1 /PP I .. �1'; PERSONAL PROPERTY .•• .,:�,, State Form 51764(R/1-06) PRIVACY NOTICE '°'• Prescribed by the Department of Local Government Finance The cost and any specific individual's salary information is confidential;the balance of the filing is public record per IC 6-1.1-12.1-5.1(c)and(d). INSTRUCTIONS: 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, 1987, and areas designated after July 1, 1987,require a STATEMENT OF BENEFITS. (IC 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 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. 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 6-1.1-12.1-4.5(I)and(g)) SECTION 1 TAXPAYER INFORMATION Name of tax ayer c AAA 734.A.r.1 u_Do o ;.s.,:oaks L. L.c_. Address of taxpayer(number and street, ity,state,and ZIP code) • > 0 ,© 4-1 VIP•B.vLA. 7 Name of contactpperson ' Telephone number 11 c.t a Z. i vt. - -, .5-7- 3" 6 SECTION 2 LOCATION ANC DESCRIPTION OF PROPOSED PROJECT Name of desi Hating body ( • Resolution number(s) 0. f)0' (O f L- - C:xtvt.G,c Location of prope /� County DLGF taxing district number 3 , COrr - : : ' � Description of manufacturing equip ,= ' r . ,. .. -. . ent ESTIMATED and/or logistical distribution equipm:n and or i f • • ment. START DATE COMPLETION DATE (use additional sheets if necessary) ti �� Manufacturing Equipment 9 R&D Equipment J0144 Vow 6-suE Logist Dist Equipment CITY CLERK,ROUYN BEND,IN IT Equipment SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT Current num,er Salaries id Number pined Number.•ditional too SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT MANUFACTURING R&0 EQUIPMENT LOGIST DIST IT EQUIPMENT NOTE:Pursuant to IC 6-1.1-12.1-5.1 (d)(2)the EQUIPMENT EQUIPMENT COST of the property is confidential. COST ASSESSED COST ASSESSED COST ASSESSED COST ASSESSED VALUE VALUE VALUE VALUE Current values V Plus estimated values of proposed project a. ,.• Less values of any property being replaced Net estimated values upon completion of project L * Ii 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 this statement are true. Signature of authorized representative Title Date signed(month,day,year)