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Filed in Clerk's Office I a STATEMENT OF BENEFITS MAR 3 L 2023 2023 PAY 20244-' 1 REAL ESTATE IMPROVEMENTS Slate Form 51707(R7/1-21) DAWN M.JONES FORM SB-1 I Real Property4.. Prescribed by the Department of Local Government Finalccrry CLERK,SOUTH BEND,IN PRIVACY NOTICEThisstatementisbeingcompletedforrealpropertythatqualifiesunderthefollowingIndianaCode(check one box): Any Information concerning the costORedevelopmentorrehabilitationofrealestateImprovements(IC 6 1.1-12.1-0) of the property and specNic safeties El Residentially distressed area(IC 6-1.1-12.1-4.1)paid to individual employees by the merry owrwr Is conrrdonbel per INSTRUCTIONS: PC t. -12.1-b.1. 1. This statement must be submitted to the body designating the Economic Revitalization Area prior to the public hearing if the designating body requiresinformationfromtheapplicantinmakingitsdecisionaboutwhethertodesignateanEconomicRevitalizationArea. 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 oftheredevelopmentorrehabilitationforwhichthepersondesirestoclaimadeduction, 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 whofailedtofileadeductionapplicationwithintheproscribeddeadlinemayfileonapplicationbetweenJanuary1andMay10ofasubsequentyear.4. A property owner who Ales for the deduction must provide the county auditor and designating body with a Form CF-1/Roal Property The Form CF-1/ReelPropertyshouldbeattachedtotheForm3224REwhenthedeductionisfirstclaimedendthenupdatedannuallyforeachyearthedeductionIsapplicable.IC 6-1.1-12.1-5.1(b) 5. For a Form S8-1/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/Reef Property trial is approved prior to July 1, 2013,the abatement schedule approved by the designating bodyremainsineffect. IC 6-1.1-12.1-17 SECTION 1 TAXPAYER INFORMATION Name of taxpayer Cross Community Inc. Address of taxpayer NumberandStreet: 707 Sherman Ave Coy South Bend Slate: IN Zip, 46616 Name at concoct person Telephone number E-mail addresa First Name-.Tina LastNamt Patton 574)876-2106 tmpatton2i comcast.net SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT Name of designating body Resolution numberCommonCounciloftheCityofSouthBend Exalter of property County DLGF taxing district numberNabrn, ,ed street 724 Harrison Avenue city South Bend Stun IN yip.46616 St. Joseph 026(South Bend Portage) Description of real property Improvements,redevelopment,or rehabilitation(use additional sheets II necessary) Estimated start date(month,day.year) We will building 2 new homes that in general will be between 1390-1620 sqft. The homes will 5/1/2023 be sold to first time homeowners who have participated in financial/credit building workshops. Esteemed completion date(month,day,year) 12/1/2023 SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT current Number Salaries Number Retained Sa4tdes Number Additional Sala des SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT REAL ESTATE IMPROVEMENTS Cunene-values COST ASSESSED VALUE 2.600 Plus estimated values of proposed project 220,000 S 242.400 Less values of any property being replaced Net estimated values upon completion of project S 220,000 245,000 SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER Estimated solid waste converted(pounds)Estimated hazardous waste converted(pounds) Other benefits The homes will be sold to first time homeowners who have participated in financial/credit building workshops. SECTION 6 TAXPAYER CERTIFICATION I hereby certify that the representations in this stateme t are true. Signature of authorized reprnsentallve Date signed(month.day year) 3/30/2023 Printed name of authorized ropresentatee Title Tina M. Patton I President Page 1of2 Filed in Clerk's c- ;.fix: l(' 2 O Lfl _'i Bianca Timriti City Clerk, South Liuhtl, IN