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"4 STATEMENT OF BENEFITS I 20__PAY 20 <br /> e t <br /> :l REAL ESTATE IMPROVEMENTS <br /> - State Form 51767(R6/10-14) FORM SB-1 I Real Property <br /> �� ` d. 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) <br /> of id to individual <br /> and specific salaries <br /> ties <br /> ❑ P P paid individual employees by the <br /> ❑Residentially distressed area(IC 6-1.1-12.1-4.1) property owner is confidential per <br /> IC 6-1.1-12.1-5.1. <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 /> 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 322/RE 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 after April 10. A property owner who <br /> failed to file a deduction application within the prescribed deadline may file an application between March 1 and May 10 of a subsequent year <br /> 4. A property owner who files for the deduction must provide the County Auditor and designating body with a Form CF-1/Real Property. The Form CF-1/Real <br /> Property should be attached to the Form 322/RE when the deduction is first claimed and then updated annually for each year the deduction is applicable. <br /> IC 6-1.1-12.1-5.1(b) <br /> 5. For a Form SB-1/Real 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 1 TAXPAYER INFORMATION <br /> Name of taxpayer <br /> The Robert Henry Corporation <br /> Address of taxpayer(number and street,city,state,and ZIP code) <br /> 404 South Frances St <br /> Name of contact person Telephone number E-mail address <br /> ( ) 574-232-2091 bhenry@roberthenrycorp.cod <br /> SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT <br /> Name of designating body Resolution number <br /> City of South Bend Common Council <br /> Location of property DLGF taxing district number <br /> 3161 Youngs Ct!County <br /> St Joseph <br /> Description of real property improvements,redevelopment,or rehabilitation(use additional sheets if necessary) Estimated start date(month,day,year) <br /> July 10, 2023 <br /> We plan to build a larger mechanic shop as our current location has been a limiting factor Estimated completion date(month,day,year) <br /> December 29, 2023 <br /> SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT <br /> Current number Salaries Number retained Salaries Number additional Salaries <br /> 210 37.597,094 210 37,597,094 4 716135 <br /> SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT <br /> REAL ESTATE IMPROVEMENTS <br /> COST 1 ASSESSED VALUE <br /> 1 Current values 1260,000 1260,000 <br /> Plus estimated values of proposed project 12,000,000 12,000,000 <br /> 1 Less values of any property being replaced 10 10 <br /> Net estimated values upon completion of project 2 260 000 2,260,000 <br /> SECTION 5 WASTE CONVERTED AND OTHEF BENEFITS PROMISED BY THE TAXPAYER <br /> Estimated solid waste converted(pounds) Estimated hazardous waste converted(pounds) <br /> Other benefits <br /> { <br /> SECTION 6 TAXPAYER CERTIFICATION <br /> I hereby certify that the representations in this statement are true. <br /> Signature of authorized representativeLi'`,7Date signed(month,day,year) <br /> (rE$Rte A R`c X23 <br /> Printed name of authorized representative Title <br /> Page 1 of 2 <br /> I <br /> 1 <br />