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• <br /> STATEMENT OF BENEFITS <br /> Filed In Cie S` <br /> '�-�°9 1 �Jrf! 20 23 PAY 2024• <br /> e REAL ESTATE IMPROVEMENTS C? <br /> Stale Form 51'>' R'i 1-211 JU� FORM SB-1/Real Property <br /> •` Prescribed by the Department of Local Government Finance // r? <br /> N C L" 7Q,� PRIVACY NOTICE <br /> ii;Statement is oeing completed for real property that qualifies under the fo 0 India3491e'::.cx ono 0n;;? Any information concerning fine cost <br /> !I Redevelopment or rehabilitation of real estate improvements(IC 6-i 1-12. ��rfNV of trio popery and;pec tic salaries <br /> �.1J paid to individual employees oy the <br /> ❑ Residentially distressed area(IC 6-1 1-12.1-4 1; CC�_K SO�O�ES property owner is confidential ear <br /> INSTRUCTIONS �N J <br /> 1 This statement must be submitted to the oody designating the Economic Revitalization Area prior to the public h .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 e hick the person wisnes to claim a deduction <br /> 2 The statement of benefits form must he submitted to the designating body ano the area designated an economic revitalization area before the initiation cf <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 they 10 m 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 atter April 10 4 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-11Real <br /> Property should be attached to the Form 322iRE when the deduction is first claimed and then updated annually For each year the deduction is applicable <br /> C 5-1 1-12 1-5 1(h) <br /> 5 For a Form SB-1/Real Property!hat 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 5-1 1-12.1-17 <br /> SECTION 1 TAXPAYER INFORMATION <br /> Name of taxpayer <br /> Five Corners LLC <br /> Address of taxpayer <br /> Nr„ ,,:,ti1Strati 814 Marietta Street cin: South Bend ;i.,t-: IN ZrP- 46601 <br /> i Name of contact person Telephone number E-mail address <br /> .ug"..„10,c,Anne Hayes I (574 ) 210-5167 ahayes@telcompark.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 /> „,i,p,, i,,,l:;„ "144 Corby Boulevard South BendIN 46617 St. Joseph <br /> " '° ''tt' i 026(South Bend-Portage) <br /> i Desamtion pf real property improvements redevelopment or rehabilitation(use additional Sheets d necessar7! Estimated start date i.mor'ih day year) <br /> Redevelopment of vacant land into two buildings featuring 108 rental 9/13/2023 <br /> Estimated completion date(month day.yeah <br /> apartment units and retail space <br /> 8!31!2025 <br /> SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT <br /> CurrentNumberSalaries Number Retar•,-' Salaries -iitlonal Salaries <br /> $ 0 0 $ 0 9 6 570.600 <br /> SECTION 4 ESTIMATED TOTAL COST AND VALUE,OF PROPOSED PROJECT <br /> REAL_ESTATE IMPROVEMENTS <br /> COST ; ASSESSED VALUE I <br /> Current values s.: I $216,200 <br /> Plus estimated values of proposed project .00,0,: s 19555 000 <br /> Less values of any property being replaced s o S 216.20o <br /> Net estimated values upon completion of project $24.500.00: $19,600,000 <br /> SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER <br /> Estimated solo waste converted(pounds) Estimated hazardous waste arvu ti <br /> Other oenefits <br /> The project is being developed to meet the National Green Building Standard for sustainability <br /> and energy efficiency. <br /> SECTION 6 TAXPAYER CERTIFICATION <br /> I hereby certify that the representations in this statement are true <br /> Signature of authorized representative ,.� date signed;mu,'r,7,day.year) <br /> 4IF ap 16/30/2023 <br /> i 0rinted name of authorized reoresantative 1 Title <br /> Anne Hayes ' Member <br /> Page 1 of 2 <br />