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�• - °'^ STATEMENT OF BENEFITS <br />x PERSONAL PROPERTY FORM SB-1 1 PP <br />t Stale Form 51764 (R3 / 12 -13) } A, r1 t <br />a' Prescribed by the Department of Local Government Finance 1 l ;nfj i1 L{' S PRIVACY NOTICE <br />i r Any information concerning the c <br />of the property and specific post <br />fic salaries paid <br />f - i to individual employees by the properly <br />owner is confidential per IC 6- 1.142.1 -5.1. <br />INSTRUCTIONS .. <br />y, 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 a person installs the new manufacturing equipment and /or research and development equipment and/or <br />logistical distribution equipment and /or information technology equipment for which the person wishes to claim a deduction. <br />2. The statement of benefits form must be submitted to the designating body and the area designated an economic revitalization area before the installation <br />of qualifying abatable equipment for which the person desires to claim a deduction. <br />3. To obtain a deduction, a person must file a certified deduction schedule with the person's personal property return on a certified deduction schedule <br />(Form 103 -ERA) with the township assessor of the township where the property is situated or with the county assessor if there is no township assessor <br />for the township. The 103 -ERA must be filed between March 1 and May 15 of the assessment year in which new manufacturing equipment <br />and /or research and development equipment and /or logistical distribution equipment and /or information technology equipment is installed and fully <br />functional, unless a filing extension has been obtained. A person who obtains a riling extension must rile the form between March 1 and the extended <br />due date of that year. <br />4. Property owners whose Statement of Benefits was approved, must submit Form CF -1 /PP annually to show compliance with the Statement of Benefits. <br />(IC 6 -1.1- 12.1 -5.6) <br />5. Fora Form SB -1 1PP that is approved after June 30, 2013, the designating body is required to establish an abatement schedule for each deduction allowed. <br />For a Form SB -11PP that is approved poor to July 1, 2013, the abatement schedule approved by the designating body remains in effect. (IC 6- 1.1- 12.1.17) <br />Name of taxpayer Name of contact person <br />Lock Joint Tube LLC Robert Strzelecki, Controller <br />Address of taxpayer (number and street, city, state, and ZIP code) Telephone number <br />515 West Ireland Road. South Bend, Indiana 46614 ( 574 ) pqq -q irr <br />Name of designating body <br />Cnmmnn r.nnnr•.il of (.h,, of 9dnnth P.nA <br />number (s) <br />Location of property County <br />DLGF taxing district number <br />515 West Ireland Road. South Bend. Indiana 46614 St. Joseph <br />026 !SB- Portadel <br />Description of manufacturing equipment and /or research and development equipment <br />and /or logistical distribution equipment and /or information technology equipment. <br />ESTIMATED <br />START DATE <br />COMPLETION DATE <br />(Use additional sheets if necessary.) <br />Proposed installation of new manucturing and /or logistical distribution equipment used in Manufacturing Equipment <br />the manufacture of steel tubing and related products having an original cost in excess of <br />11/0112014 <br />11/01/2015 <br />$3,300,000. R & D Equipment <br />Logist Dist Equipment <br />11)01/2014 <br />11/01/2015 <br />IT Equipment <br />• • • • • •• -• •• -• <br />Current number Salaries Number retained Salaries Number additional Salaries <br />193 - 10.3MM 193- $10.3MM 1 6 -8 - $189k -$251k <br />• IN <br />• • • • <br />• •••• • ••• <br />NOTE: Pursuant to IC 6- 1.1- 12.1 -5.1 (d) (2) the <br />MANUFACTURING <br />EQUIPMENT <br />R & D EQUIPMENT <br />LOGIST DIST <br />IT EQUIPMENT <br />COST of the property iS confidential. <br />EQUIPMENT <br />COST <br />ASSESSED <br />COST <br />ASSESSED <br />COST <br />ASSESSED <br />ASSESSED <br />VALUE <br />VALUE <br />VALUE <br />COST <br />VALUE <br />Current values <br />$12.2 <br />$3.40 <br />Plus estimated values of proposed project <br />1,000,000.00 <br />Re 16 <br />300,000.00 <br />a 16 <br />Less values of any property being replaced <br />N A <br />N A <br />N A <br />A <br />Net estimated values upon completion of project <br />$15.2 <br />Re 16 <br />00, 000 <br />eg 16 <br />Estimated solid waste converted (pounds) <br />Estimated hazardous waste converted (pounds) <br />Other benefits: <br />I hereby certify that the representations in this statement are true. <br />Si atur of a o' ed repr nl <br />Date signed (month, day, year) <br />March , 2014 <br />Printed name of authorized re nlative <br />Title <br />Robert Strzelecki - <br />Controller <br />Page 1 of 2 <br />