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APPLICATION FOR DEDUCTION FROM ASSESSED VALUATION <br />n i OF STRUCTURES IN ECONOMIC REVITALIZATION AREAS (ERA) <br />Stale Form 18379 (131211 -14) <br />% Prescribed by the Department of Local Government Finance <br />20 i3 PAY 20 74 <br />FORM 322 /RE <br />INSTRUCTIONS. <br />1. This form is to be filed in person orby mail with the County Auditor of the county in which the property /s located. <br />2. To obtain this deduction, a Form 3221RE must be filed with the CounlyAudiforbefore May 10 in the year in which the addition to assessed valuation (or <br />new assessment) is made, ornot leterthan thirty (30) days after the assessment notice Is mailed to the property ownerif it was mailed aRerApril 10. If the <br />property owner misses the May 10 deadline in the initial year of assessment he can apply between March i and May 10 of a subsequent year trthe <br />remainder of the abatement term. (See also IC 6-1,1- 12.1.11.3 concerning the failure to file a timely application.) <br />3. A copy of the Form 11, the approved Form SB -1 /Real Property; the resolution adopted by the designating body, and the Fonn CF -1 /Real Property must <br />be attached to this application. <br />4. The Form CF -1 /Real Property must be updated annually and provided to the County Auditor and the designating body for each assessment yearin which <br />the deduction is applicable. <br />5, Please see IC 6-1.1 -12.1 for further instructions. <br />6. Taxpayer completes Sections 1,11 and III below. <br />7. If property located in an economic revitalization area is also located in an allocation area as defined in IC 36 -7 -14-39 or IC 36 -7- 15.1 -26, an application for <br />the property lax deduction may not be approved unless the Commission that designated the allocation area adopts a resolution approving the application <br />(IC 6 -1.1. 12.1- 2(k)), <br />8. Except for deductions related to redevelopment or rehabilitation of real property in a county containing a consolidated city, a deduction for the <br />redevelopment or rehabilitation of real property may not be approved for the following facilities (IC 6-1.1- 12.1 -3).: <br />a. Private or commercial golf course ). Any facility, the primary purpose of which is (a) Retail food and beverage <br />b. Country club service; (b) Automobile sales orservice; or (c) other retail,• (unless the <br />C. Massage parlor facility Is located in an economic development- target area established <br />d. Tennis club under IC 6 -1.1- 12.1 -7). <br />e. Skating facility, including roller skatin, skateboarding of ice skating k. Residential, unless the facik is a mu)fi- Famlly fact 14 that contains at <br />g 01 g 9 9 4 least 20% of the units available for use by low and moderate income <br />f Racquet sport facility (Including handball or racquet ball coon) individuals or unless the facility is located in an economic development <br />g. Hot tub facility target area established under IC 6 -1.1- 12.1 -7, or the area is designated <br />h. Suntan facility as a residentially distressed area which is required to meet oonalhons as <br />I. Racetrack cited in IC 6-1.1- 12.1 -2 (c) (1 8 2). <br />1. Package liquor store [see IC 6 -1.1 -12.1 - 31e1r1211 <br />SECTION I- DESCRIPTION OF PROPERTY <br />The owner hereby applies to the County Auditor fora deduction pursuant to IC 6- 1.1- 12.1.5 beginning with the assessment date March 1, 20 <br />County <br />Township <br />DLGF taxing district number <br />Key number <br />St. Joseph <br />South Bend - German <br />009 <br />025- 1009 -14605 <br />Name of owner <br />Legal description from Form 11 <br />Ameriplex Superior Partners LP Wife Ontario Partners LP <br />Lot 1 Portage Prairie Minor #3 NP #26014128/09 <br />Property address (number and street, city, state, and ZIP code) <br />Date of Form 11 (month, tlay, year) <br />5231 Dylan Drive, South Bend, IN 46628 <br />11/5/2013 <br />Type of shucture <br />Use or structure <br />Industrial <br />Governing body that approved ERA designation <br />Dale ERA designation approved (month, day, year) <br />Resolufion number <br />City of South Send <br />2/5/2013 <br />4238 -13 <br />SECTION II - VERIFICATION OF OWNER OR REPRESENTATIVE <br />Signature of owner or eprasenle0ye (r hereby certify that the representations on this appifcalion are true.) <br />Date signed (month, day, year) <br />5/5/2014 <br />Printed name of owner orrre representative <br />p <br />Address (number street. dty, state, and ZIP code) <br />Timothy A. Baker <br />227 S. Main St., Suite 200, South Bend, IN <br />SECTION III- <br />STRUCTURES <br />s e <br />A. Rehabilitation structure 1. Assessed valuation AFTER rehabilitation <br />$ <br />2. Assessed valuation BEFORE rehabilitation <br />$ <br />3. Difference In assessed valuation (Line 1 minus Une 2) <br />$ <br />4. Assessed valuation eligible for deduction <br />$ <br />(for the increase In AN from the rehabilitation, not including <br />the Increase in AN (Tom the reassessment of the entire <br />structure) <br />S. New structure 1. Assessed valuation <br />$ 3,347,100.00 <br />2.Assessecivaluallonali blefordeduction <br />$ 3133,300.00 <br />SECTION IV- VERIFICATION OF ASSESSING OFFICIAL. <br />1 verify that the above described structure was assessed and the owner was notified on <br />with the <br />effective dale of the assessment being March 1, 20 and that the assessed valuations in SeUlon III are correct <br />Signature ofAasessirg Oletlal <br />Printed name of assessing official <br />Date (month, day, year) <br />CONTINUED ON THE REVERSE SIDE <br />