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STATEMENT OF BENEFITS <br />PERSONAL PROPERTY <br />State Form 61764(14/1.00) <br />Prescribed by the Department of Local Government Finance <br />INSTRUCTIONS: <br />1. 7hls stelementmuat be submlked 10 Ma <br />to the <br />FORM SB•1 /PP <br />PRNAC eY�&aNOT�ICE <br />b�ianc♦aa MCnY� NOTICE d'Nee <br />IC6- i.t•12.1d.1 c and d� <br />o,.�wmn aaagne,eu Haar vury 1, Jaai regmree S7gTEhfEMTOFBENEFlT &(IC 6- f.1.12.f)� - °•�p1°�OOaraommrUadfo efierJuly J, J96', <br />2. Approval alike deslgnatingbody (C/1ycound/, Town Board. County Counag etaJ Oust be oblanedpdorro /naaleUon alhenewmanaeaudng equipmen <br />andpproveamh and devo/opmam equipment and/or1o91aUCel dh7dbuUOn equ/pmeid aMilviroorma6on lechndogyequlpmenl, <br />BEFORE, tleducUonmay <br />be approved <br />3. To obtain a deduction, a person must Me a ce?IBad deduction schedule will the p'"an"s personal proparlY slum on A 00MIed dedua rx, Schedule (Form <br />103 -ERA) with the township assessor of the township whore the properly As Ousted' The 103 -ERA must be Madbebvean March f and May 16 of the <br />assessment year In which nowmanrdachrdnil equipment and/or research and development equipment eM/or loyisUeel d/stlbution equipment enNor <br />Rtethe Ularm between March 1 and iUre euendeddufe pr to o1U ofyea�a Boo hasbeanablaned gperson w1+a oble/nsahDn9 eMenaion must <br />4. property owners whose Statement of BeaeMs was approved aterJune 30, 1991, ntua submh Form CF-1 /Pp annually to show minal ance With UIe <br />StatemantofBeneRfs. <br />6. The achodaeeesteblfahadunderIC B -f.t- 12.1- 4.6(rtJ and(e) applyro equipmenlinsisiadaherMamh 1, 2001. Forequ /pmentlnsWadpdarlo Macon 2, <br />2001, the schadaes andstetaesin efiaaaf the Into shatcontinue 6 apply. (IC B•1.1- 121.4.8(/) and (g)) <br />me of legayer -..— <br />South Bend Gear, LLC <br />rdreasaWpeyer(nwnberandsaeet, Ulx stem, antlLPepe) q <br />3849 Showedux Drive, South Bend, Indiana 46629 JAN `L 0 201 <br />3949 Showedux Drive, South Bend, Indiana <br />See attached 2 sheets. <br />R 6 D Equipment <br />LOglst DBt Equipment <br />IT Equipment <br />0 10.00 0 <br />0 0 <br />0 .00 0.00 12 5 <br />550,000.00 <br />NOTE: Pursuant M <br />MANUFACTURING u <br />R 8 D EQUIPMENT LO GIST D18T . <br />COST of the property is confidenfial. C <br />E U9'MENT I <br />ITEOUIPMENT <br />COST E <br />CST CoSi ASSESSED C <br />COST ASSESSM <br />Curenlvalues a <br />am 000 W <br />VALUE <br />Plus estimated values a proposed pr at l <br />lsn =00 6xgl.oln.00 <br />Less values ofanyproperty being replaced 0 <br />000 0.00 <br />Net estimated values upon completion of project u <br />uam,aaom 6,3aopoom <br />• • . <br />. r a <br />Esfimated soGdwage converted (pounds) E <br />Estimated hazardous warts. com iced (pouMa) <br />Deer benefits: <br />Al • <br />