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� sr�ru I{1 VILat�& li$'adO... <br />STATEMENT OF BENEFITS Lny "I LERK > `e''r; ;c Lid?. I <br />PERSONAL PROPERTY FDRfI SB -17 "PP <br />saevm5,T6aIR2r,2 "> 141 2014 i <br />Prescribed by the Department of Local Govemment Fran <br />1 PRIVACY NOTICE <br />The mat ad erry •padre hdNiduall <br />:s:::.�.;,;. ,.SCPVU, I6V batanee orma111nnpph ere reran <br />INSTRUCTIONS er IC 61.1- 12.td.1 c ant d. <br />1. This statement must be submitted to the body designating the EcorlDmIc RevifeliretPon Area prior to (he public hearing if the designating body requires <br />Information from the epplkent in mak-ng its decision about whatherto designate an Economic RevlalLwflenAms. Otherwise this statement must be submitted <br />to the designating body BEFOREe person installs the new manufacturing squlpmerd andkrresearch and development equipment androrlogJ'fi'&dlsbtbudon <br />aequipment <br />d eras desl9 cInformation <br />ted Re July �8��ul�STATEMEN70FBFNEFITS. (ICB- 1.1_deduction. •Pm /ogs•pJenned orcommitted OO aflerJUfy i, 1987, <br />� ( 121) <br />2. Appfovalolthe designating body(Cffy Coun li Town Board, County ouncO, etc. must be obtinadpriorto lnslellasonoirdo nowmenufacturl <br />andrormsearch and development equipment ry ) n8 equipment <br />be approved q pmenl anNorfogisfbal distribution equipment end/orhlormafion technology equipment BEFOREe deducu'm may <br />3. To Obtain a deduction, a person must We a ccrOOed deduction schedule with the person's personal properlyreWm on a cedMed deduction achaduie (Form <br />fO3 -ERA) with the township assessor of the township where the property is situated or with the county assessor h there Is no township as for the <br />township. The 103 -ERA must be bled between March 1 and May 15 of the assessment year In which new msnuferlurirg equipment erM/or research and <br />development equipment sndla logistical distribution equipment and/or Informallon technology equipment is instated andlute /y funcdonal, unless a filing <br />extension has been obtained A person who obtains a filing extension must Ole the form between March 1 and the extended due date of that year. <br />4. Property owners whose Statement of SeneSte was approved after June 30, 1991, must submit Form CF-1 i PP annually to show compitance with the <br />StatemeniolBenafrs. CIC61.1- 12.1 -5.6) <br />5. The schedules estbdshed underlC 6-1. f- 121- 4.5(d) and (e) apply 10 equipment insteiled after March 1, 2001, unless en aliemative deduction schedule is <br />adopted by the designating lady pC 61.1 - 12.1 -17). <br />Address of laxpey� r q � � Q dsireef, �tY. sl�ra, a i 2 <br />L I- <br />«tt <br />Nem¢o /caelact person <br />Jess` V <br />Name of designating body <br />IRQ►J <br />Socalbn of properly AA <br />e number <br />-2Z9 -g6U -% <br />tot <br />Im/ng or-Ird rMber <br />1(ZQf�.. -.'�_. . oJl elcsa�a �1sar�eutS STARTOATE Go DATE <br />L.)'l`e- L�eJa2, T'^uty 4r,�.,ErS- A..a �s•): i� +s ort Manufaduring Equipment .� <br />r1Na� ce s iru `t y +r.bl'ut -� 6dr m�4Cr�0 �LeRd0Equipment <br />4eoxet <br />''4-I 1f�1r:. r.� -1`f� r (.rplel Diet C-qui menl <br />�f� ucEO �.riS 'I�C ;NV4LLJ,`on e� 2 dr.u��,.. P ' zO iti A <br />r-re.2r—r $" v , R Equipment <br />r 3 -2c�f 3 -2vila <br />Current nV bar Saladea <br />Num retain - r <br />ed Salaries <br />1 JOO, f>C� . cn Ste, D nC� . rip Numberrddltiond Salanae � <br />NOTE: Pursuant to IC 6- 1.1- 12.1 -5.1 (d) (2) the I en <br />COST of the property, is confidential. fl --��� <br />Estimated solid waste converted (pounds) <br />Otherbenetaa: <br />R 6 D EOUIPMENT LOGIST DIST I R EQUIPMENT <br />E UIPMENT <br />FC0,9 TTASMMSEDI <br />COST vi COST I ASSE& <br />Estimated hazardous waste coms -Ld (pounds) <br />this <br />Page 1 of 2 <br />are <br />pnea (m", dex <br />3— 14 - <br />