Bill No. 23-45 Crossroads Solar Enterprises LLC Declaratory 1901 Bendix Dr.

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Filed in Clerk's Office JUL 0 5 2023 «,,�,,•,,� STATEMENT OF BENEFITS DAWN M.JONES FORM SB-1 'PP y - 'i PERSONAL PROPERTY CITY CLERK,SOUTH BEND,IN x' i State Form 5175d(R5 i 1-21) PRIVACY NOTICE � � Prescribed by the Department of Local Government Finance Any information concerning the cost of the properly and speofic salares paid to individual employees by the property owner is confidential pet IC 6-1.1-12.1-5.1 INSTRUCTIONS I This srateinent must he submitted to the body designating rim 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;lrstnbuuon equipment and/or information technology equipment 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 installation of qualifying abatable equipment for which the person desires to claim a deduction 3 To octain a deduction.a person must file a certified deduction schedule with fuse 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 or with the county assessor it there is no township assessor for the township The 103-ERA must be hied between January 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 heen obtained A person who obtains a filing extension must file the form between January 1 and the extended due date of that year 4 Property owners whose Statement of Benefits was approved,must submit Form CF-1/PP annually to show compliance with the Statement of Benefits (1C 6-1 1-12 1-5 6, 5 For a Form SB-1/PP that is approved after June 30.20.13 the designating body is required to establish an abatement schedule for each deduction allowed. For a Form SB-1/PP that is approved prior to July 1.20+3 the abatement schedule approved by the designating body remains in effect 'IC 6-1 1-12 I-17) SECTION 1 TAXPAYER INFORMATION Name of taxpayer Name of contact person :nRegan Crossroads Solar Enterprises LLC First Milne. Patrick LodNac Address of taxpayer Telephone number Cor.,d .,m,I,,..-4,V,, 1901 N. Bendix Dr South Bend 0:,1x IN sir 46628 (607)759-1058 ......r-.....--.. SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT Name of designating body Resolution number(s) Common Council of the City of South Bend Location of property County DLGF taxing district number V,1➢b[ chit,,R01- 1901 N. Bendix Dr (“r South send st,.:,-IN z, 46E28 St.Joseph 026(South Bend-Portage) Description of manufacturing equipment and/or research and development equipment ESTIMATED and/or logistical distribution equipment and/or information technology equipment. START DATE COMPLETION DATE !Use addhttonal sheets if necessary! The equipment is a fully automated solar panel assembly Manufacturing Equipment line. It will include a laminator, sun simulator, framing, R&D Equipment /soldering unit and numerous conveyors. This equipment will increase our productive capacity by 4X. Logist Dist Equipment IT Equipment SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT Current Number 1 Sward.' Q 582 4�0 Number Retained 14 Salaries 582,4�� Number Additional 15 Salaries 750,000 SECTION 4 J ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT NOTE:Pursuant to IC 6-1.1-12.1-5.1(d)(2j the MANUFACTURING R&D EQUIPMENT EQUIPMENT IT EQUIPMENT , EQUIPMENT COST of the property is confidential. COST ASSESSED COST ASSESSED COST ASSESSED COST ASSESSED VALUE VALUE VALUE VALUE Current values $o Plus estimated values of proposed project $1.000000 Less values of any property being replaced 5 0 Net estimated values upon completion of protect 5'On7.i,o0 $0 $0 $0 $0 I $'' $0 $0 SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER Estimated solid waste converted ipou,uis) 0 i estimated hazardous waste converted(pounds) 0 Diner benefits. — SECTION 6 TAXPAYER CERTIFICATION i I hereby dy that th• representat this statement are torr Sign.tur or autho' ed• pies live Dale sig d condi day year) bd`P -i , 7 / i-306,- P- - .I-n n,.te of outhunted ewes . :tie, Title Page 1 of 2