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Filed in Clerk's Office <br />i1""4.,\ STATEMENT OF BENEFITS 2024 PAY 2025 <br />7- REAL ESTATE IMPROVEMENTS MAY Q 8 2024 FORM SB-1/Real Propertya, 3r <br />0State Form 51767(R7 11-21)P y <br />Prescribed by the Department of Local Government Finance <br />hh <br />Bianca Tirado PRIVACY NOTICE <br />This statement is being completed for real property that qualifies under the followirhgltrYdPa'harCooP kidk5t3 arj.'N Any information concerning the cost <br />Redevelopment or rehabilitation of real estate improvements(IC 6-1.1-12.1-4) <br />of itd to individualv ande specific salariesties <br />paid employees by the <br />i] Residentially distressed area(IC 6-1.1-12.1-4.1)property owner is confidential per <br />IC 6-1.1-12.1-5.1. <br />INSTRUCTIONS: <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 properly 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 Properly. 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 S8-1/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 Properly 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 />Cross Community, Inc <br />Address of taxpayer <br />Number and Street: 707 Sherman Ave City: South Bend State IN ZIP' 46616 <br />Name of contact person Telephone number E-mail address <br />First Name: Tina Last Name: Patton 574)876-2106 tmpatton2@comcast.net <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 Number and Street City State ZIP County DLGF taxing district number <br />728 Harrison Ave South Bend IN 46616 St. Joseph 026(South Bend-Portage) <br />Description of real property improvements.redevelopment,or rehabilitation(use additional sheets el necessary) Estimated start date(month,day,year) <br />We will build one (1) new home that will be between 1390-1620 sq ft with 3 06/03/2024 <br />bedrooms, 2 bathrooms, with a garage. <br />Estimated completion date(month,day,year) <br />11/30/2024 <br />SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT <br />Current Number Salaries Number Retained Salaries Number Additional Salaries <br />SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT <br />REAL ESTATE IMPROVEMENTS <br />COST ASSESSED VALUE <br />Current values 4,300 <br />Plus estimated values of proposed project 270,000 220,300 <br />Less values of any property being replaced <br />Net estimated values upon completion of project 270,000 224,600 <br />SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER <br />Estimated solid waste converted(pounds) <br />0 Estimated hazardous waste converted (pounds) <br />0 <br />Other benefits <br />The home will be sold to a first-time homeowner who has participated in financial/credit building <br />workshops <br />SECTION 6 TAXPAYER CERTIFICATION <br />I hereby certify that the representations in s statement are true. <br />Signature of aulho. representati 1 Date signed(month,day,year) <br />Pinted name of auli-orir_ed representative tin <br />Tina M Patton President <br />Page 1 of 2