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..,,, <br />~"~ STATEMENT OF BENEFITS <br />7 ' `^.. - <br />State Form 27167 {R7! 12-01) <br />R Y <br />~~1~ ~ Prescribed by the Department of local Government Finance <br />~oRM <br />SB - 't <br />INSTRUCTIONS: <br />1. This statement must be submtted to the body designating the economic revitflization area prior to the public hearing if the designating body requires infor- <br />mation from the applicant fn making ifs decfs on about whether to designate an Economic Revltalizatlon Area. Otherwise this statement must be submitted <br />to the designating body Bt:FORE a parson fnsfafls the new manufacturing equipment and 1 or research and development equipment, or BEFORE the <br />redevelopment or rehabdrtatron of real property for whfch the person wishes fo claim a deduction. 'Projects" planned or committed to after July i, T 98T and <br />areas designated afterJuly 1, 1987 require a STATEMENT OF SENEFtTS. (1C &f.f-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 rehabilitation, <br />or prior to instaila6on of the new manufacturing equipment and I orresearoh and development equipment, BEFOREa deduction may be approved. <br />3. To obtain a deduction, Form 322 ERA, Real Estate improvements and I or Form 322 ERR 1 PPME and 1 or 322 ERA I PPR & Dt ;must be filed with the <br />county auditoi With respect fo real prepert}; Form 322 ERA must ba filed by the later oh. (1) May 10; or (Z) fhirty~30) days after a notice of increase in real <br />property assessment is received from the township assessor. Form 322 ERA i PPME and / or 322 ERA R & b must be fried between March 1 and May <br />15 of the assessment year in which new manufacturing equipment and 1 or research and development equipment becomes assessable, unless a filing <br />extension has been obtained. A person who obtains a filing extension must fife the form between March 1 and the extended due date of that year. <br />4. Property owners whose Statement o/Benefits was approved after June 30, T99f must submit Form CF- i annually to show compliance with the Statement <br />ofBene~is. (lCti-l.l-i2.1-5.5) <br />5. The schedules esfablfshed under IC 8-1.T-12.4-4(d) and 1C 6-1.1-t2.1-4.5 (e) effective July T, 2000 apply to any statement of benefits filed on or after <br />July f, 2000. <br />The schedules effective prior to July T, 2000 shall continue fo apply to those statement of benefits filed before Juty 1, 2000. <br />~' <br />• <br />Name of taxpayer, <br />~f25T ~Rd~-t-- S~Jf!~JC~S I~A~1~ <br />A dress of taxpayer (street and number, city, state and Z1P code) <br />~ / <br />~o I ,CAST t Tf-{- ST~~T"1 TAO., t~~ SZ7r ~~Ct-t.ESTE-/L , ~II.J rfito~75'c~SZ~ <br />Name of contact >person <br />~2c- <br />~lz <br />c <br />f I~ <br />t~~+ <br />c~ i Telephone number <br />siA~) Z23 - 2~ z~_ <br />c <br />, <br />5 <br />1c{-t-A2~j <br />.~. <br />~ <br />. , <br />. <br /> <br />- <br />Name of designaGn body Resolution number <br />/ <br />Scou'i-l-} ~~N ~ C~`~Pn/Vlor~1 ~~,.f ct l~ <br />Location of property <br />' :. ~:~ SE '~A SEC.-,~orJ a~to,'i 3~ (~l ~ ~Z- F' County <br />s~ - Sasr~.Pti- Taxing district <br />F~2F_ <br />Description of teat property improvements acid ! or new manufa~uring equipment and / or ESTIM ATED <br />arch and development equipment (use additional sheets if necessary) t <br />ti <br />D <br />l <br />C <br />rese Start Date a <br />e <br />on <br />e <br />omp <br />~~oU.S VNDSJ~r.o pp~ SI1J(TI.F - rA~~4~ Real Estate vti~TL`. 7~,~q~ ZOt <br />~`SIt7~nI'f1Arl- tjDTS ~GA-~ ~ wmft~l Ro~/A~^ ~-K New MfgEquipmenf <br />t~4ur <br />lc- <br />J 2t <br />Q3 <br />' <br />.. <br />no~.. <br />, - <br />3, Ta <br />LETS . <br />~Sl~~ ~, ~c- <br /> R&DE <br /> <br />Current number Salaries Number retained Saiarles Number additional Sala ries <br /> <br />NOTE: Pursuant to IC 6-1,1-12.1-5.1 (d) (2) the Real Estate Improvements Machinery Research and Development <br />Equipment <br />COST of the property is confidential. - Cost Assessed Value Cost Assessed Value Cost Assessed Value <br />Current values ~ pA,Oir./T f{2Gf ~, ~ I ~ OD <br />Plus estimated values of proposed project q ?1lS, o00 <br />Less values of any property being replaced f•! <br />Net estimated values upon completion of project q 24S,ooo <br />~ .. -. <br />Estimated solid waste converted (pounds) ~i Estimated hazardous waste converted (pounds) NA <br />Other benefds: N~ <br />• ~ <br />I hereb certi that the re resentations in this statement are true. <br />Signature of authorized representative Title nth, day, year) <br />Date signed (m <br />o <br /> ~ <br />/ <br />