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STATEMENT OF BENEFITS
<br />REAL ESTATE IMPROVEMENTS
<br />State Form 51767 (112 / 1 -07)
<br />Prescribed by the Department of Local Government Finance
<br />This statement is being completed for real property that qualifies under the followi
<br />�1 Redevelopment or rehabilitation of real estate improvements (IC 6 -1.1- 12.14)
<br />Eligible vacant building (IC 6- 1.1- 12.14.8)
<br />Filed In Clerk's Of ;c
<br />JVL 2 r- 2013
<br />India Code (check one box):
<br />JOHN VOORDE
<br />CITY CLERK, SOUTH SEND IN
<br />20 PAY 20_
<br />SB -1 / Real Property
<br />INSTRUCTIONS. r
<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 rehabiNation of real property for which the person wishes to claim a deduction.
<br />'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)
<br />2. Approval of the designating body (City Council, Town Board, County Council, etc.) must be obtained prior to iniliation of the redevelopment or rehabilitation,
<br />BEFORE a deduction may be approved.
<br />3. To obtain a deduction, application Form 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 mailed to the property owner at the address
<br />shown on the records of the township assessor.
<br />4. Property owners whose Statement of Benefits was approved after June 30, 1991, must attach a Form CF- ?/Real Property annually to the application to
<br />show compliance with the Statement of Benefits. [IC 6 -1.1- 12.1- 5.1(b) and /C 6 -1.1- 12.1 - 5.36)]
<br />5. The schedules established under /C 6 -1.1- 12.1 -4(d) for rehabilitated property and under /C 6 -1.1- 12.1- 4.8(1) for vacant buildings apply to any statement
<br />of benefits approved on or after July 1, 2000. The schedules effective prior to July 1, 2000, shall continue to apply to a statement of benefits filed before
<br />July 1, 2000.
<br />SECTION I TAXPAYER
<br />INFORMATION
<br />Name of taxpayer
<br />NW
<br />Address of taxpayer (number and street, city state, and ZIP code)
<br />13-7 7 ; Hill /'eL i jJ
<br />Name of contact person
<br />Telephone number
<br />E-mail address
<br />1 `50 -
<br />�jdos►t,WN►,�ricl Z�lk
<br />SECTION 2 LOCATION AND DESCRIPTION
<br />OF PROPOSED PROJECT
<br />Name of designating body
<br />:F.Fuax on number
<br />Location of property , - r t
<br />County -.-
<br />ting district number
<br />Current number i Salaries
<br />(use additional sheets if
<br />Number retained
<br />Estimated start date (month, day, year)
<br />Estimated completion date (month, day, year)
<br />Number additional (Salaries
<br />NOTE: Pursuant to IC 6-1.1- 12.1 -5.1 (d) (2) the COST of the property REAL ESTATE IMPROVEMENTS_
<br />is confidential. .COST ASSESSED VALUE
<br />Current values 1
<br />Plus estirr)ated values of proposed project 2 j t) °v
<br />Less values of any property being replaced
<br />Net estimated values upon completion of Droiect .. „
<br />Estimated solid waste converted (pounds)
<br />Estimated hazardous waste converted (pounds)
<br />Other benefits
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<br />AVunt' ,e,v "Fsf M4 5 o>r *- ulh^i- /'S = pfd -1w Wlu t lo It. Cap eVed ks,R e lexe,
<br />on Ay Pr odc4 IZ2, 3y in �and liu *t5 in U/Z f I'le Ud3). Qxregh r ,&d
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<br />I hereby certify that the representations in this statement are true.
<br />Signature of authorized representative
<br />Title
<br />Page 1 of 2
<br />Date signed (month, day, year)
<br />
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