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-o J IMI EIVICIV I ur tstINtrl I J <br /> ,z4 % REAL ESTATE IMPROVEMENTS 20_PAY 20_ <br /> f State Form 51767(R7/1-21) FORM SB-1 /Real Property <br /> `-.%4-1.`�� 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 /> 0 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 /> INSTRUCTIONS: IC 6-1.1-12.1-5.1. <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 January 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 /> RealAmerica Development, LLC <br /> Address of taxpayer 8250IN <br /> Number and Street: Dean Road city: Indianapolis State: ZIP: 46240 <br /> Name of contact person \ L Telephone number E-mail address <br /> f ir �i <br /> si amn r. I V 11 ke Lasl Name. S u ra k (317) 815-5929 msurak©realamericallc.com <br /> SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT <br /> Name of designating body Resolution number <br /> Common Council of the City of South Bend <br /> Location of property I County DLGF taxing district number <br /> Number and Street; 504 S Lafayette Blvd Ciiy; South Bend yiatc: IN Zip.46601 St. Joseph 026(South Bend-Portage) <br /> Description of real property improvements,redevelopment,or rehabilitation(use additional sheets if necessary) Estimated start date(month,day,year) <br /> This will be a 60-unit market-rate sister building to Diamond View Apartments. 10/1/2023 <br /> Estimated completion date(month,day,year) <br /> 3/1/2025 <br /> SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT <br /> Current Number Salaries O 0 Number RetainedSalaries $ O 2 Number AdditionalSalaries <br /> 0 $ 85,000 <br /> SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT <br /> REAL ESTATE IMPROVEMENTS <br /> COST ASSESSED VALUE <br /> Current values $8,000 $8,000 <br /> Plus estimated values of proposed project $10,710,500 $2,650,125 <br /> Less values of any property being replaced $8,000 $8,000 <br /> Net estimated values upon completion of project $10,710,500 $2,650,125 <br /> SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER <br /> Estimated solid waste converted(pounds) o Estimated hazardous waste converted(pounds) o <br /> Other benefits <br /> SECTION 6 TAXPAYER CERTIFICATION <br /> I hereby certify that the representations in this statement are true. <br /> Signature of authorized representative Date signed(month,day,year) <br /> 5/31/2023 <br /> Printed name of authorized representative -Title <br /> Ronda Shrewsbury I President <br /> Page 1 of 2 <br />