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STATEMENT OF BENEFITS 20 26 PAY 20 27 <br /> REAL ESTATE IMPROVEMENTS FORM SB-1/Real Property <br /> State Form 51767(R8/5-25)ca PRIVACY NOTICE <br /> Prescribed by the Department of Local Government FinanceAny information concerning the cost <br /> This statement is being completed for real property that qualifies under the following Indiana Code(check one box): of the property and specific salaries <br /> ✓E Redevelopment or rehabilitation of real estate improvements(IC 6-1.1-12.1-4) property owner is confidential per <br /> Residentially distressed area(IC 6-1.1-12.1-4.1) IC 6-1.1-12.1-1.1. <br /> New agricultural improvement(IC 6-1.1-12.1-4) paid to individual employees by the <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 art Economic Revitalization Area.Otherwise,this statement must be <br /> submitted to the designating body BEFORE the initiation of the redevelopment or rehabilitation of real property or a new agricultural improvement for <br /> which the person wishes to claim a deduction. <br /> 2. 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 <br /> 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 failed to <br /> file a deduction application within the prescribed deadline may file an application between January 1 and May 10 of a subsequent year. <br /> 3. 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- <br /> I/Real Property should be attached to the Form 322/RE when the deduction is first claimed and then updated annually for each year the deduction <br /> is applicable.iC 6-1.1-12.1-5.1(b) <br /> 4. 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. <br /> SECTION 1 TAXPAYER INFORMATION <br /> Name of Taxpayer <br /> David A Nufer, LLC <br /> Address of Taxpayer(number and street,city,state,and ZIP code) <br /> 2409 Mishawaka Ave., South Bend, IN 46615 <br /> Name of Contact Person Telephone Number Email Address <br /> David Nufer (574 ) 340-9750 davidanufer@gmail.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 County DLGF Taxing District Number <br /> 2614-2626 S.Main St,109 W.Eckman Street,South Bend, IN 46614 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 /> A new Burton's Laundry on the current vacant land. The existing building on 06/01/2026 <br /> the north side of the of the property will be used for storage. .Estimated Completion Date(moat,day,year) <br /> 12/31/2027 <br /> SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES FROM PROPOSED PROJECT <br /> Current Number 1 Salares Number Retained Salaries Number Additional Salaries <br /> 0 0 0 0 4 $96,000 <br /> SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT <br /> REAL ESTATE IMPROVEMENTS <br /> COST ASSESSED VALUE <br /> Current Values $0 $14,800 <br /> (+)Plus Estimated Values of Proposed Project $1,200,000 $720,000 <br /> (—)Less Values of Any Property Being Replaced $0 $0 <br /> Net Estimated Values Upon Completion of Project $1,200,000 $734,800 <br /> SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER <br /> Estimated Solid Waste Converted(pounds) 0 Estimated Hazardous Waste Converted(pounds) 0 <br /> Other Benefits: <br /> SECTION 6 TAXPAYER CERTIFICATION <br /> I hereby .edify that the represen. ions his schedule are true. <br /> Signature.1 Authorized Re ese =tiv Date 7onth,day,year) <br /> Ia6 <br /> Printed ••e of Authonz d Re re ern A, e Title <br /> Page 1 of 2 <br />