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STATEMENT OF BENEFITS 20 PAr2o_
<br /> REAL ESTATE IMPROVEMENTS —
<br /> ` , State Farts 51787(R2/1-07) FORM SB-1/Rql Property
<br /> Prescribed by the Department of Local Government Finance
<br /> This statement is being completed for real property that quelKes under the following Indiana Code(check one box):
<br /> 2 Redevelopment w rehabilitation of real estate improvements(IC 61.1-12.1A)
<br /> ❑ Eligible vacant building(IC 6-1.112.14.8)
<br /> INSTRUCTIONS'
<br /> 1. This statement must be submitted to the body designating the Economic Revfbsllzetfon Area prior to the public hearing E the designating body mollies
<br /> in board pn from the applicant in making its decision about whether to designate an Economic Revitalization Ama. Otherwise this statement must be
<br /> submitted to the designating body BEFORE the redevelopment orrehabilitation ofreal property for which the person wishes to claim a deduction.
<br /> 'Pro/acts'planned or committed to after July 1, 1987,and areas designated after July 1, 1987,require a STATEMENT OF BENEFITS. (IC 61.1-12.1)
<br /> 2. Approval of the designating body(City,Council, Town Board,County Council,etc.)must be obtained prior to Initiation of the redevelopment or rehabifdalion,
<br /> BEFORE a deduction may be approved.
<br /> 3. To obtain a deduction,application Form 322 ERA/RE or Form 322 FRANBD, 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-1/Real Properly annually to the application to
<br /> show compliance with the Statement ofBenefts. flC 6-1.1-12.1-5 f(b)and fC 6-1.1-12.1-5.36))
<br /> 5. The schedules established under IC 61.1-12.1-4(d)for rehabilitated property and under IC 6-1.1-121-4.8(1)for vacant buildings apply to any statement
<br /> of benefits approved on or after July 1,2000. The schedules effective prior to July',2000,shall continue to apply to a statement of benerds riled before
<br /> July 1,2000.
<br /> • ki
<br /> Name of taxpayer
<br /> Maria Jose Fernandez Moreno and Francisco de Asis Martinez Jerez
<br /> Address of taxpayer(number and sheet,city,stab,and Z1Pcode)
<br /> 80541 Ashford Lane, Granger, IN 46530
<br /> Name of canted person Teleplw•le number E-mail address
<br /> Francisco de Asis Martinez Jerez (574)631 95
<br /> asismartinez @nd.etlu
<br /> Name of designating body
<br /> common Council Resolution number
<br /> Location of property County DLGF taxing district number
<br /> 1028 Notre Dame Avenue,South Bend, IN St.Joseph
<br /> Description of real properly improvements,redevsopmem,or iehabllitation(use additional sheets If necessary) Estimated std date(month,day,year)
<br /> Prairie style house with four bedrooms,office,family and dining room,two-car garage 11/15/2013
<br /> around 3,800 sgft. and probably finished basement. Esumaled comilletio,date(mome,dey can
<br /> .,,t. • , -
<br /> 06/30/2014
<br /> Y
<br /> Curren number Salaries Number retained Salaries ..
<br /> Number add,bonal Salaries
<br /> k
<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
<br /> Current values - 75.000.00 ASSESSED VALUE
<br /> _
<br /> Plus estimated values of proposed project _ 550.000.00
<br /> Less values of any property being replaced
<br /> Net estimated values upon completion of project 625,000.00
<br /> Estimated solid waste converted(pounds) Estimated hazardous waste converted(pounds)
<br /> Other DenePls - - pp ,��,// In "^ (f a•9
<br /> "' 2 2 z013
<br /> CITY CLEktt, .;�;,I's2Np,IN
<br /> I hereby certify that the representations in this statement ar rue.
<br /> Signature ofauthoraed ntabve Tae
<br /> Date elgrtad(rtronttr,day,yver) !
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