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STATEMENT OF BENEFITS <br /> REAL ESTATE IMPROVEMENTS <br /> i State form 51767(R3112-11) <br /> - ✓` Prescribed by the Department of Local Government Finance F®��S�-f f Real property <br /> This statement is being completed for real property that qualifies under the following Indiana code(check one box): <br /> ® Redevelopment or rehabilitation of real estate improvements(IC 6-1.1-12.10 <br /> ❑ Eligible vacant building(IC 6-1.1-12.1-4.8) <br /> INSTRUCTIONS_ <br /> I- This statement must be submitted to the body designating the Economic Ravilaftzation Area prior to the public hearing ff 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 /> Arojects'planned or committed to after July 1,1987,and areas designated after July 1, 1987,require a STAT1=/,BENT pF BENEFITS_ (a 6.1.1.121) <br /> 2. Approval of the designating body(City Council, Town Board,County Council,etc.)must be obtained priorto inrtia6on of the redevelopmenf or rehabilitation, <br /> BEFORE a deduction may be approved. <br /> 3. To obtain a deduction,appficafon Farm 322 ERA/RE or Form 322 ERA/VBD, Whichever is applicable,must be filed with the County Auditor by the later <br /> of-(1)May 10;or(2)thirty(30)days after the notice of addition to assessed valuation or new assessment is m rty owner of the address <br /> to the prope <br /> shown on the records of the township assessor,if any,or the county assessor. <br /> 4. Property owners whose Statement of Benefits was approved after June 30, 1991, must attach a Form CF-1/Reat property annually to the application to <br /> show compliance with the Statement of Benefits. (1C 6-1.1-12.1-5 1(b)and!C 6-1.1.12.1-5.3d)j <br /> 5. The schedules established under!C 6-1.1-12.1-4(d)for rehabilitated property and under 1C 6-1.1-12.1-4.8(1)for vacant buildngs apply to any statement <br /> of benefits approved on or after July 1,2000,unless an alternative deduction schedule is adopted by the designating body PC 6-1.1-12.1-17). The <br /> schedules effective prior to July 1,2000,shalt continue to apply to a statement ofbenefils filed bafore July 1,20011_ <br /> e ®- <br /> F e of taxpayer <br /> TAMPICO DEVELOPMENTS, LLC <br /> ess of taxpayer(numb-and street city state,and ZIP code) <br /> 37 RIVER POINTE PLACE, MISHAWAKA, IN 46544 <br /> Name of contact person Telephone number <br /> DENNIS SCHWARTZ E mall address <br /> 574 255-1503 dschw1940 2ol.cafn <br /> Name of designating body <br /> CITY OF SOUTH BEND COMMON COUNCIL Resolution number <br /> Location of property 3926-08 <br /> County 3926-08 <br /> taxing district number <br /> NW 114, SECTION 32, TOWNSHIP 37N, RANGE 3E ST. JOSEPH 033 <br /> Description of real property improvements,redevelopment,or rehabit Cation(use additional sheets if necessary) <br /> Estimated smart date(month,day,year) <br /> CRESCENT OAKS, SECTION TWO- 18 RESIDENTIAL SINGLE-FAMILY LOTS 2013 <br /> .(4 ALREADY DEVELOPED/STARTED) Estimated completion date(month,day,year) <br /> +l-5 YEARS <br /> Current number Salaries Number retained Salaries Number additional Salarias <br /> N/A N/A N/A N/A N/A N/A <br /> 7Plusel nt to IC 6-1.1-12.1-5.1 (d)(2)the COST of the property REAL ESTATE IMPROVEMENTS <br /> COST ASSESSED W�LiE <br /> 540 000.00 71,900.00 Parent Parcel <br /> values of proposed project 2 700,000.00 <br /> Less values of any property being replaced <br /> Net estimated values upon completion of project 3,240 000.00 <br /> Estimated solid waste converted(pounds) N/A Estimated hazardous waste converted(pounds) N/A <br /> Otherbenefits <br /> NIA <br /> ri 3 1 L <br /> �1 L 1�ialo�ISi'k� •:r t,.1 Rj.•,.k.s...�'9+''� i� <br /> i hereby ' that the representations in this staters tare true.Sigrtatur f a onzed rep r Mall Title Date signed(month,day,year) <br /> SOLE MEMBER ar ®! <br /> Page 1 of 2 <br />