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vierr. J vlfice ) <br /> a <br /> I <br /> j �1AY 1 ; 2021 <br /> oiwo!� <br /> STATEMENT OF BENEFITS j DAWN�i JGNES 20PAY20_ <br /> REAL ESTATE IMPROVEMENTS ! CI-TYCLcR;< SOUTti8ENDState Form 51767(R6/10-14) —"" —' FORM SB-11 Real Property <br /> Prescribed by the Department of Local Government Finance <br /> PRIVACY NOTICE <br /> This statement is being completed for real property that qualifies under the following Indiana Code(check one box)- Any information concerning the cost <br /> Redevelopment or rehabilitation of real estate improvements(IC 6-1.1-12.1-4) of the property and specific salaries <br /> paid to individual employees by the <br /> ❑Residentially distressed area(IC 6-1.1-12.1-4.1) property owner is confidential per <br /> IC <br /> INSTRUCTIONS. <br /> 1. This statement must be submitted to the body designating the Economic Revitalization Area priorto 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 thepe rson wishes to claim a deduction. t <br /> 2. The statement of benefits form must be submitted to the designating body and the area designated an economic revitalization area before the initiation of <br /> the redevelopment or rehabilitation for which the person desires to claim a deduction. <br /> 3. To obtain a deduction,a Form 3221RE must be filed with the County Auditor before May 10 in the year in which the addition to assessed valuation is <br /> made or not later than thirty(30)days after the assessment notice is mailed to the property owner if it was mailed atterApril 10 A property owner who <br /> failed to file a deduction application within the prescribed deadline may rile an application between March land May 10 of a subsequent year. <br /> 4. A property owner who files for the deduction must provide the CountyAuditor and designating body with a Form CF-I/Real Property. The Fonn CF-1rReal <br /> Property should be attached to the Form 322NE when the deduction is first claimed and then updated annually for each year the deduction is applicable. <br /> lC 6-1.1-12.1-5.l(b) <br /> 5_ For a Form SB-1yReal Property that is approved after June 30, 2013, the designating body is required to establish an abatement schedule for each <br /> deduction allowed. For a Form SB-1/Real Property that is approved prior to July 1, 2013, the abatement schedule approved by the designating body <br /> remains in effect. IC 6-1.1-12.1-17 <br /> "SECTION <br /> _44AXPAYER INFORMATION <br /> Name of taxpayer <br /> GLC Portage Prairie V, LLC <br /> Address of taxpayer(numherand street,city,state,and ZIP code) <br /> 130 S Main St. Suite 320, South Bend, IN 46601 <br /> Name of contact person Telephone number E-mail address <br /> ( ) 574-276-1897 ihall@greatlakescapital.com <br /> SECTION 2 DESCRIPTION OF PROPOSEDPROJECT <br /> Name of designating body Resolution number <br /> City of South Bend <br /> Location of property County St. Joseph DLGF taxing district number <br /> ) <br /> Description of real property Improvements,redevelopment,or rehabilitation(use additional sheets ifnecessary) Estimated start date(month,day,year) <br /> June 1,2022 <br /> 296,400 SF warehouse building on 30 acres of land in the Ameriplex Industrial Park Estimated completion date(monh,day,year) <br /> Jan. 1, 2024 <br /> -SECTION 3 ESTIMAT.itOFEMPLOYEESANDeALARIESAS RESULT OF PROPOSED PROJECT <br /> Current number Salaries Number retained Salaries Number additional Salanes <br /> 0 50-200+ $18 1 <br /> ESTIMATEDSECTION 4 . PROPOSED <br /> REAL ESTATE IMPROVEMENTS <br /> COST ASSESSED VALUE <br /> Current values 900,000 <br /> Plus estimated values of proposed project 15,000,000+ Asssessed Per Req 17 <br /> Less values of any property being replaced I <br /> Net estimated values upon completion of project 15 000,000 Asssessed Per Req 17 <br /> SECTION 5 WASTE CONVERTED D OTHER BENEFITS PROMISED _ <br /> Estimated solid waste converted(pounds) Estimated hazardous waste converted(pounds) <br /> Other benefits <br /> i <br /> f <br /> SECTION • <br /> I hereby certify that the representations in this statement are true. <br /> Signature of authorized repres� tative Date signed(month,day,year) <br /> MA tb �LZ '• <br /> Printed name of authorized repr a 11ve Title <br /> 3 E F= = SrAamc M hti <br /> Page 1 of 2 <br /> i <br /> t <br />