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°9'm /�RF/° o l� 4Y{ fa <br /> c i ? 4 STATEMENT OF BENEFITS • -K: „ L FORM SB-1/PP <br /> 1 PERSONAL PROPERTY <br /> I n Y R J▪ f Prescribed by the Department of Local Government Finance IV PRIVACY NOTICE , <br /> t 1'r The cost and any In�vidual s <br /> t w sale information is oonfidentiat;the 1�^7 <br /> balance of the filing Is public record 1:-,,a3,-... ? <br /> per IC 6-1.1-12.1-5.1(c)and(d). n r <br /> �� fUCTIONS: { <br /> 11. , statement must be submitted to the body designating the Economic Revitalization Area prior to the public hearing if the designating body requires • ;,,;,>°"-' <br /> P P 9 9 u Y q ; <br /> x v ation from the applicant in making its decision about whether to designate an Economic Revitalization Area Otherwise this statement must be submitted ` <br /> it�: e designating body BEFORE a person installs the new manufacturing equipment and/or research end development equipment,and/or logistical distribution `•" t <br /> illipment and/or Information technology equipment for which the person wishes to claim a deduction. 'Projects"planned or committed to after July 1, 1987, ^ <br /> tir,,,ci,areas designated alter July 1, 1987,require a STATEMENT OF BENEFITS. (IC 6-1.1-12.1) <br /> i roval of the designating body(City Council Town Board,County Council,etc.) must be obtained prior to Installation of the new manufacturing equipment r, V, <br /> ,p } 4 or research and development equipment and/or logistical distribution equipment and/or information technology <br /> pproved equipment,BEFORE a deduction may `,' <br /> K,,,,,, <br /> r I btain a deduction,a person must file a certified deduction schedule with the person's personal property return on a certified deduction schedule(Form ,5 ' <br /> `s ;:;1-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 ,;; <br /> '), •zsssment year in which new manufacturing equipment and/or research end development equipment and/or logistical distribution equipment and/or ' 1,1 <br /> . ,l{matIon technology equipment Is Installed and fully functional,unless a filing extension has been obtained. A person who obtains a filing extension must <br /> r$1 the form between March 1 and the extended due date of that year. <br /> < • I.arty owners whose Statement of Benefits was approved after June 30, 1991,must submit Form CF-1/PP annually to show compliance with the f, <br /> :} ment of Benefits. (IC 6-1.1-12.1-5.6) tk <br /> schedules established under IC 6-1.1-12.1-4.5(d)and(e)apply to equipment installed after March 1,2001. For equipment installed prior to March Z `>< <br /> ▪ • 1,the schedules and statutes In effect at the time shall continue to apply. IC 6-1.1-12.1-4.5 and <br /> ,1 $. .TION 1 TAXPAYER INFORMATION <br /> � # tpf taxpayer £o' s <br /> g th Bend Gear, LLC t4,41, of taxpayer(number and street,city,stele,and ZIP code) ,?' <br /> r '� „t9 Showerlux Drive,South Bend,Indiana 46628 <br /> ,' if contact person .- <br /> Telephone number ,. <br /> ;t •i Blenke r , <br /> ■ (574)234-4116 <br /> t 1 , ' h10N 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT <br /> i k4 s:of designating body Resolution number(s) g tY, ` <br /> ', ,,t1'.•:4.ath Bend Common Council <br /> 1 )',. n of property County DLGF taxing district number <br /> ,4, $9 Showerlux Drive,South Bend,Indiana 46628 St.Joseph 71-009 r <br /> iption of manufacturing equipment and/or research and development equipment T.` ' <br /> a2 t x logistical distribution equipment and/or information technology equipm t. ESTIMATED ; <br /> x 1 jdditional sheets if necessary) , START DATE COMPLETION DATE , <br /> 4 i, , `*: Manufacturing Equipment I ze II V a r z°f' • z`.?' <br /> ,. le attached 2 sheets. 'AI <br /> i 4. <br /> 1 <br /> a '' R&D Equipment "; <br /> .1,$„..,74 C -.,.: Logist Dist Equipment <br /> P IT Equipment ,. '' <br /> - 1 'TION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT <br /> • jnumber Salaries • ' ti-4,; <br /> i, Number retained Salaries Number additional Salaries R <br /> r ' 0.00 0 0.00 12 `'' <br /> -1,,,,,� ' 550,000.00 a <br /> 1i* T1ON 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT l <br /> A , MANUFACTURING LOGIST DIST y,ll <br /> +1 E:Pursuant to IC 6-1.1-12.1-5.1(d)(2)the R&D EQUIPMENT <br /> EQUIPMENT EQUIPMENT IT EQUIPMENT i, <br /> -,,i< v )'of the property is confidential. COST ASSESSED <br /> r. ASSESSED COST ASSESSED 1..,.t.T., <br /> i it.a y '.; _ VALUE VALUE COST COST ASSESSED <br /> VALUE <br /> <4 i t nt values 0.00 0.00 VALUE <br /> t t t *~estimated values of proposed project 15.600.000.00 6.240.000.00 — r t <br /> ` E values of any property being replaced o.o0 0.0o <br /> 0timated values upon completion of project is.soo.000.0o 6.240,000.00 <br /> 1 -TION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER <br /> i. F sated solid waste converted(pounds) Estimated hazardous waste converted(pounds) <br /> 1 ;Jbenefits. <br /> I.:::.• <br /> g tai employees to be hired is estimated to be 26 by the completion date. <br /> `t° ,`:.TION 6 TAXPAYER CERTIFICATION <br /> �� airr:4 <br /> hereby certify that the representations In this statement are true. -' <br /> ;,',:,'''1";...' ire of authorized representative Title Date signed(month,day,year) <br /> Manager 1 0112812011 <br /> t l O S oa,.4,f4L 7M.yi r,aa-21CR4,-4. ,1 cL'F/AT�'n,t-1,c...,...,yy„, Cm--f r1•e:Q.•;.-f 1 <br />