Reconfirming Tax Abatement - 5405 Royal Street for Tampico Developments LLC

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STATEMENT OF BENEFITS REAL ESTATE IMPROVEMENTS `• State Form 51767 (83112 -11) t+' _; �, �� Prescribed by the Department of Local Government Finance This statement is being completed for real property that qualifies under the following Indiana Code (check one box): m Redevelopment or rehabilitation of real estate improvements (IC 6-1.1- 12.1 -4) ❑ Eligible vacant building (IC 6-1.1- 12.1 -4.8) 20 PAY 20_ FORM SBA I Real Property INSTRUCTIONS: 1. This statement must be submitted to the body designating the Economic Revitalization Area prior to the public hearing if the designating body requires information from the applicant in making its decision about whether to designate an Economic Revitalization Area. 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. Projects" planned or committed to after July 1, 1987, and areas designated after July 1, 1987, require a STATEMENT OF BENEFITS. (IC 6 -1.1 -12.1) 2. Approval of the designating body (City Council, Town Board, County Council, etc.) must be obtained prior to initiation of the redevelopment or rehabilitation, BEFORE a deduction may be approved. 3. To obtain a deduction, application Form 322 ERA/RE or Fora 322 ERA/VBD, Whichever is applicable, must be filed with the County Auditor by the later of., (1) May 10, or (2) thirty (30) days after the notice of addition to assessed valuation or new assessment is mailed to the property owner at the address shown on the records of the township assessor, if any, or the county assessor. 4. Property owners whose Statement of Benefits was approved after June 30, 1991, must attach a Form CF -1 /Real Property annually to the application to show compliance with the Statement of Benefits. (IC 6- 1.1- 12.1- 5.1(b) and IC 6-1.1- 12.1 - 5.30)] 5. The schedules established under IC 6 -1.1- 12.1 -4(d) for rehabilitated property and under IC 6 -1.1 -12.1- 4.8(1) for vacant buildings apply to any statement of benefits approved on or after July 1, 2000, unless an alternative deduction schedule is adopted by the designating body (iC 6-1.1- 12.1 -17). The schedules effective prior to July 1, 2000, shall continue to apply to a statement of benefits filed before July 1. 2000. SECTION •- • Name of taxpayer TAMPICO DEVELOPMENTS, LLC Address of taxpayer (number and street, city, state, and ZIP code) 737 RIVER POINTE PLACE, MISHAWAKA, IN 46544 Name of contact person Telephone number E-mail address DENNIS SCHWARTZ 574) 255 -1503 dschw1940 aol.com SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT Name of designating body Resolution number CITY OF SOUTH BEND COMMON COUNCIL 3862 -08 Location of property County DLGF taxing district number 5405 ROYAL STREET I ST. JOSEPH 033 Description of real property improvements, redevelopment, or rehabilitation (use additional sheets if necessary) Estimated start date (month, day, year) LOT 3 OF CRESCENT OAKS, SECTION 1A 2013 Estimated completion date (month, day, year) + / -1 YEAR SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT - Current number Salaries Number retained Salaries Number additional 7alaries N/A N/A N/A N/A N/A N/A SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT NOTE: Pursuant to IC 6 -1.1- 12.1 -5.1 (d) (2) the COST of the property REAL ESTATE IMPROVEMENTS is confidential. COST ASSESSED VALUE Current values 30 000.00 500.00 Plus estimated values of proposed project 155,000.00 Less values of any property being replaced N/A Net estimated values upon completion of project 185,000.00 SECTION • ■ AND OTHER BENEFITS PROMISED BY THE TAXPAYER Estimated solid waste converted (pounds) N/A Estimated hazard wed ounds) N/A Other benefits i 9-118cl in ` erw n N /A-- A iD6d�3 IiV 17 �.. +8.9�•:y �� 0..q•:t \iITV CLERK, JB� 3`s BEND, IN t SECTION I hereby ce ' fy that the representations in this statement are true. Signature of ut rued reproentativ Title Date signed (month, day, year) SOLE MEMBER ,¢ O/Z / �� Page 1 of 2 l