5027-23 CONFIRMING a Declaratory Resolution Area Known as: 521 N. William St., SB

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"''• STATEMENT OF BENEFITS �l j;\ 4i� 2023 PAY 20 2� y; REAL ESTATE IMPROVEMENTS A. _ State Form 51767(R7/1-21) FORM SB-1 I Real Property —" ` + Prescribed by the Department of Local Government Finance ens PRIVACY NOTICE This statement is being completed for real property that qualifies under the following Indiana Code(check one box): Any information concerning the cost ment or rehabilitation of real estate improvements(IC 6-1.1-12.1-4) of id to property and specific salaries the es ED Redevelopment p paid individual employees by t ❑ Residentially distressed area(IC 6-1.1-12.1-4.1) property owner is confidential per IC 6-1.1-12.1-5.1. 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 the redevelopment or rehabilitation of real property for which the person wishes to claim a deduction. 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 the redevelopment or rehabilitation for which the person desires to claim a deduction. 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 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 failed to file a deduction application within the prescribed deadline may file an application between January 1 and May 10 of a subsequent year. 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 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. IC 6-1.1-12.1-5.1(b) 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 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 remains in effect. IC 6-1.1-12.1-17 SECTION 1 TAXPAYER INFORMATION Name of taxpayer David A Nufer LLC Address of taxpayer Number and Street: 2409 Mishawaka Ave City: South Bend State: IN ZIP: 46615 Name of contact person Telephone number E-mail address First Name: David Last Name: Nufer (574) 340-9750 davidanufer@gmail.com SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT Name of designating body Resolution number Common Council of the City of South Bend Location of property County DLGF taxing district number Number and Street: 521 N.William Street City,South Bend State: IN ZIP:46616 St. Joseph 026 (South Bend-Portage) Description of real property improvements,redevelopment,or rehabilitation(use additional sheets if necessary) Estimated start date(month,day,year) New 6,304 sq ft building for laundry and retail space 6/1/2023 Estimated completion date(month,day,year) 12/31/2023 SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT Current Number Salaries$ 80,000 Number Retained Salaries $ 80 000 Number Additional 0 Salaries $ 0 O SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT REAL ESTATE IMPROVEMENTS COST ASSESSED VALUE Current values $o $0 Plus estimated values of proposed project $1,600,000 $1,280,000 Less values of any property being replaced $0 $0 Net estimated values upon completion of project $1,600,000 $1,280,000 SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER Estimated solid waste converted(pounds) 0 Estimated hazardous waste converted(pounds) Other benefits SECTION 6 TAXPAYER CERTIFICATION I her y certify that the representations in this statement are true. Signal - of author zed re re e1, Date signed(month,day,year) 4 s 5-a3 Prin ed name of authorized representative Title4,14 s /VSarL /1/�,. /i U 7�C/ N6 f'Y�d c v--- Page 1 of 2