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HomeMy WebLinkAboutConfirming Tax Abatement - Enzyme Research Laboratories, Inc. 1801 Commerce Dr. (5 Year Personal Property)RESOLUTION NO. 3 SS -(� - a �O A RESOLUTION CONFIRMING THE ADOPTION OF A DECLARATORY RESOLUTION DESIGNATING CERTAIN AREAS WITHIN THE CITY OF SOUTH BEND, INDIANA, COMMONLY KNOWN AS 1801 COMMERCE DRIVE TO BE AN ECONOMIC REVITALIZATION AREA FOR PURPOSES OF A FIVE (5) YEAR PERSONAL PROPERTY TAX ABATEMENT FOR ENZYME RESEARCH LABORATORIES, INC. WHEREAS, the Common Council of the City of South Bend, Indiana, has adopted a Declaratory Resolution designating certain areas within the City as Economic Revitalization Areas for the purpose of tax abatement consideration; and WHEREAS, a Declaratory Resolution designated the area commonly known as 1801 Commerce Drive, South Bend, Indiana, and which is more particularly described as follows: E PT LOT 25 AIRPORT INDUSTRIAL PARK PHASE II- SEC 33- 38 - 2E CONT .40 ACRES + / -. W 287 FT OF LOT 25 AIRPORT INDUSTRIAL PARK PHASE II SW 1- 4 SEC. 33 -38 -2E 1.57 ACRES S 80.5 FT OF LOT 24 SW AIRPORT INDUSTRIAL PARK PHASE II SEC 33 -38 -2E and which has Key Numbers 025 -1008- 033502; 025- 1008 - 033508; 018 - 2183- 688612; 018- 2183- 688603, as an Economic Revitalization Area; and WHEREAS, notice of the adoption of a Declaratory Resolution and the public hearing before the Council has been published pursuant to Indiana Code 6- 1.1- 12.1 -2.5; and WHEREAS, the Council held a public hearing for the purposes of hearing all remonstrance's and objections from interested persons; and WHEREAS, the Council has determined that the qualifications for an economic revitalization area have been met. NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of South Bend, Indiana, as follows: SECTION I. The Common Council hereby confirms its Declaratory Resolution designating the area described herein as an Economic Revitalization Area for the purposes of tax abatement. Such designation is for Personal property tax abatement only and is limited to two (2) calendar years from the date of adoption of the Declaratory Resolution by the Common Council. SECTION II. The Common Council hereby determines that the property owner is qualified for and is granted Personal property tax deduction for a period of five (5) years, and further determines that the petition complies with Chapter 2, Article 6, of the Municipal Code of the City of South Bend and Indiana Code 6- 1.1 -12 et seq. SECTION III. This Resolution shall be in full force and effect from and after its adoption by the Common Council and approved by the Mayor. PRESENTED `- L3 -0b N01 APPROVED n Member o ommon Council Filed In Clerk S (){flee DEC } g 2005 so. 1200 Couwy -CITY BUILDING 227 W JEFFERSON BOULC- ARD SOUTH BEND, INDIANA 46601 -1830 PHONE 574 /235 -9371 FAx 574/235 -9021 TDD 574/ 235 -5567 CITY OF SOUTH BEND STEPHEN J. LUECKE, MAYOR COMMUNITY & ECONOMIC DEVELOPMENT December 16, 2005 SHARON T. KENDALL EXECUTIVE DIRECTOR Council Member Ann Puzzello, Chairperson Community & Economic Development Committee South Bend Common Council 4th Floor, County City Building South Bend, IN 46601 RE: Personal Property Tax Abatement Petition for: Enzyme Research Laboratories, Inc. Dear Council Member Puzzello: Please find attached the Department of Community & Economic Development's report on a personal property tax abatement petition for the above referenced petitioner. Also attached is a copy of the petition, Statement of Benefits form and supporting information. The project calls for the acquisition and installation of new equipment as part of the company's planned acquisition and rehabilitation of its new facility located at 1801 Commerce Drive. A separate petition is being submitted to the Council for the rehabilitation of the building. The report contains the Department's findings relative to the above petition. Enzyme Research Laboratories, Inc. will be purchasing and installing new equipment. The total project cost for the equipment is estimated at $800,000. The project meets the qualifications for five (5) year personal property tax abatement and a representative from Enzyme Research will be available to meet with the Committee on Monday, January 9, 2006. Should you or any of the other Council members have any questions concerning the report or need additional information, please feel free to call me at 235 -5826. Sincerely, Bob Mathia Assistant Director, Economic Development Attachments cc: South Bend Common Council Members Mayor Stephen Luecke Sharon Kendall Don Inks COMMONm DEVELOPMENT ECONOMIC DEVELOPMENT FINANCIAL & PROGRAM PAMELA C. MEYER DONALD E. INKS MANAGEMENT 574/235 -9660 574/235 -9371 ELIZABETH LEONARD FAx: 574/235 -9697 574/235 -9371 1200 COUNTY -CITY BUILDING 227 W. JEPFERSON BOULEVARD SOUTH BEND, INDIANA 46601 -1830 PHONE 574 /235 -9371 FAx 574/235 -9021 TDD 574/ 235 -5567 CITY OF SOUTH BEND STEPHEN J. LUECKE, MAYOR COMMUNITY & ECONOMIC DEVELOPMENT SHARON T. KENDALL EXECUTIVE DIRECTOR TAX ABATEMENT REPORT TO: SOUTH BEND COMMON COUNCIL FROM: BOB MATHIA SUBJECT: PERSONAL PROPERTY TAX ABATEMENT PETITION FOR: ENZYME RESEARCH LABORATORIES, INC. 1801 COMMERCE DRIVE DATE: December 16, 2005 On December 15, 2005, a petition for personal property tax abatement consideration for property located at 1801 Commerce Drive filed with the City Clerk by Enzyme Research Laboratories, Inc. Pursuant to Chapter 2, Article 6, Section 2 -77 of the Municipal Code of the City of South Bend, this petition was referred to the Department of Community and Economic Development for purposes of investigation and preparation of a report determining whether the area qualifies as an Economic Revitalization Area pursuant to I.C.6 -1.1 -12.1 and whether all zoning requirements have been met. The Department of Community and Economic Development has reviewed the petition (a copy of which is attached), investigated the area and makes the following report. PROJECT SUMMARY The project encompasses the relocation and expansion of two biotechnology companies, Enzyme Research Laboratories, Inc., (ERL) and R2Diagnostics (R2D). ERL is a primary supplier of coagulation and fibrinolytic proteins for research. R21) manufacturers and sells clot based diagnostic kits that are used for bleeding and clotting disorders. Both companies are wholly owned by Mike Morris who is acquiring a larger facility to house them. The total project includes the acquisition and rehabbing of the larger facility and the purchase of additional equipment for the move and expansion. This petition relates to only the purchase of the equipment. A separate petition is being submitted for COMMUNITY DEVELOPMENT ECONOMICDEVELOPMENT FINANCIAL .&'PROGRAM PAMELA C. MEYER DONALD E. INKS MANAGEMENT 574/235 -9660 574/235 -9371 E•uzA nH LEONARD FAX: 574/235 -9697 5741235 -9371 South Bend Common Council RE: Tax Abatement for Enzyme Research Laboratories, Inc. December 16, 2005 Page 2 the rehabilitation of the larger facility. Currently, both firms are housed in a 9,000 sq. ft. building located at 412 S. Lafayette Blvd. The larger facility is a 25,423 sq. ft. building located at 1801 Commerce Drive. That building sits on a 2.64 acre site. The project will result in increased production capacity and an expanded product line. The estimated cost for acquisition of the equipment is $800,000. This tax abatement petition is for the equipment purchase only. EMPLOYMENT IMPACT Per the petition, it is estimated that the total project will create six (6) new, permanent, full -time jobs representing a new annual payroll of $300,750. The project will also maintain eleven (11) existing permanent full -time jobs representing an annual payroll of $324,200. ABATEMENT QUALIFICATION A review of the tax abatements previously granted, finds that the petitioner has not been granted or associated with any previous tax abatement. 2. The building commissioner has reviewed the petition and finds the property to be properly zoned for the proposed project. A review of the South Bend Redevelopment designation areas finds that the property is located in the Airport Economic Development Area, which is a Tax Incremental Allocation Area, therefore, the petition for personal property must first be approved by the South Bend Redevelopment Commission. 4. A review of the Tax Abatement Ordinance no. 8065 -90 finds that the petitioner meets the qualifications for a five (5) year personal property tax abatement under section 2 -84.2 (Tangible Personal Property Tax Abatement). Tax Abatement Schedule prepared for: Enzyme Research Laboratories, Inc. South Bend German 5 Year Personal Property Abatement Schedule' Total Taxes Due During Abatement: $69,652 Total Taxes Abated During Abatement: $45,813 Total Taxes Paid During Abatement: $23,839 - This schedule is for estimation purposes only and assumes constant tax rates. The true tax values will ulimately be determined by the actual assessed valuation and the then current tax rates. 12/17/2005 Tax Paid $0 $4,021 $6,032 $6,893 $6,893 $23,839 Total estimated Equipment Cost $800,000 Assume constant tax rate of: 4.874 Assume constant SRTC rate of: 7.9223 TTV Assessed Gross Less Net Percent Tax Year TTV% (Year 1 -5) Value Tax SRTC Tax Abated Abated 1 40% 320,000 320,000 $15,597 1,236 $14,361 100% $14,361 2 56% 448,000 448,000 $21,836 1,730 $20,106 80% $16,085 3 42% 336,000 336,000 $16,377 1,297 $15,080 60% $9,048 4 32% 256,000 256,000 $12,477 988 $11,489 40% $4,595 5 24% 192,000 192,000 $9,358 741 $8,617 20% $1,723 $75,645 5,993 $69,652 $45,813 Total Taxes Due During Abatement: $69,652 Total Taxes Abated During Abatement: $45,813 Total Taxes Paid During Abatement: $23,839 - This schedule is for estimation purposes only and assumes constant tax rates. The true tax values will ulimately be determined by the actual assessed valuation and the then current tax rates. 12/17/2005 Tax Paid $0 $4,021 $6,032 $6,893 $6,893 $23,839 CITY OF SOUTH BEND PETITION FOR TANGIBLE PERSONAL PROPERTY TAX ABATEMENT CONSIDERATION The undersigned owner(s) of new manufacturing equipment, personal property, located within the City of South Bend, hereby petitions the Common Council of the City of South Bend for personal property (new manufacturing equipment) tax abatement consideration and pursuant to I.C., 6 -1.1 -12.1, et se and South Bend Municipal Code Section 2- 84.52, et se . for this petition states the following: 1. Describe the proposed project, including information about the new manufacturing equipment personal property (equipment) to be installed, the amount of land to be used, if any, the proposed use of the equipment, and a general statement as to the value of the project to your business. This project encompasses the expansions and relocation of two biotechnology companies. Enzyme Research Laboratories Inc a 24 year old ISO 9001-2000 registered company and R2Diagnostics Inc. (R2D), an 8 -year old ISO 13485 registered company. Enzyme Research Laboratories (ERL) intends to purchase equipment in 2006 in the amount of $350,000, and in 2007 in the amount of $450,000 for a total purchase amount of $800,000. In addition to these purchases the Company intends to purchase furniture and fixtures in the amount of $35,000 over the next 2 1/2 years and $45,000 in computer hardware during the same time period. ERL is s primary supplier of coagulation and fibrinolvtic proteins for the research community. Since its inception in 1982 ERL has become the world leader for quality and value within the industry. R2D manufactures and sells clot based diagnostic kits that test for bleeding and clotting disorders. The expansion and purchase of this additional equipment is necessary to increase the production capacity in both the purified protein line along with increasing the product offerings of R2D. 2. The project will create 6 new, permanent jobs within the first year, representing a new annual payroll of $ 300 750 and will maintain 11 existing permanent full-time and 0 existing part -time jobs representing an annual payroll of $ 324.200 . The projected annual salaries for each new position created are estimated to be as follows: Lab Tech ERL $33,800 - $46,200 Lab Tech R21) $33,800 - $46,200 Research Chemist R21) - $91,000 - $110,500 (The above amounts were computed using the average hourly rate with fringe benefits.) 1 3. Estimate the total cost of the Equipment: $8002000 4. (a) The Equipment is owned or to be owned by the following individuals or corporations (if the business organization is publicly= held, indicate also the name of the corporate parent, if any, and the name under which the corporation has filed with the Securities and Exchange Commission): NAME ADDRESS INTEREST Enzyme Research Laboratories 1801 Commerce Dr. South Bend IN (b) The following other persons lease, intend to lease, or have an option to buy this Equipment (include corporate information as required in (4)(a) above, if applicable): NAME ADDRESS INTEREST N/A 5. . Give a brief description of the overall nature of the business and of the operations occurring at the location for which tax abatement is requested: ERL is a primary supplier of coagulation and fibrinolytic proteins for the research community. The Company' s products are distributed worldwide to researchers and pharmaceutical companies to aid in the development of novel therapeutic compounds and assays to diagnose and treat coagulation/ hemostatis disorders R21) manufactures and sells clot based diagnostic kits that test for bleeding and clotting disorders. R2D uses the proteins from ERL to insure the highest quality final products with no lot -to -lot variation. These two points are critical to testing labs like the South Bend Medical Foundation who rely on our quality for patient care. 6. The commonly known address of the property where the Equipment is to be located is: 1801 Commerce Drive South Bend IN 7. The Key Number of said property is: 025- 1008 - 033502; 025 - 1008 - 033508; 018 - 2183 - 688612; 018 - 2183- 688603 8. Attach the legal description of the property where the equipment is to be located, marked Exhibit A, and is hereby incorporated herein. 9. Attach a map and /or plat describing the property where the equipment is to be located, marked Exhibit B, and is hereby incorporated herein. 10. Attach photographs of the property, taken within 30 days of filing of this petition, marked Exhibit C. and hereby incorporated herein. 11. The current assessed valuation of the tangible personal property to be replaced by the new manufacturing equipment is $ No equipment being replaced Additional equipment being purchased for expansion (This information may be obtained from the St. Joseph County Assessors office 235 -9523) 12. The current use of the real property where the Equipment is to be installed is Light Industrial and the current zoning is LI (use) and N/A (height and area). (This information may be obtained from the Building Department 235 -9553) 13. List the real and personal property taxes paid at the location during the previous five years, whether paid by the current owner or a previous owner: YEAR REAL PROPERTY TAXES PERSONAL PROPERTY TAXES 04 -05 30 457.54 03 -04 30 477.91 (This information may be obtained from the St. Joseph County Treasurers office 235 -9531) 14. Describe the commitment made within the past five years by your firm to hiring minority individuals, including number of minorities employed during each of the past five years, specifying whether full time or part -time and whether permanent or temporary employees. The Petitioner shall also list the current number of total employees (full and part -time) and the current number of minority individuals (full and part - time). ERL and R21) are equal opportunity employers who do not discriminate in hiring, promotion discharge pay, fringe benefits and other aspects of (Revised 8/2/02) 3 employment on the basis of race, color, religion, sex or national origin. 15. Describe on -site child care or day care facilities, services or benefits currently offered or proposed to be offered by the Petitioner for children of employees. There will be a designated " Kid Zone" for children of employees to use after school The hours of the laboratory are 7:00 am - 4:00 pm. The children will be utilizing this his space for approximately 1 hour a day. The room will have computers and study tables as well as games for the children to use while they are waiting for their mother or father. This is not intended to be for all day care nor for children under school age. Currently no employees have children under school age. 16. What is your best estimate of the market value of the new Equipment after installation? $ 800,000 17. What is your best estimate of the amount of taxes to be abated during each of the five years after installation? $ 44,400 (See attached computation 18. What is the commitment your firm will make to minority employment during the five years of tax abatement? ERL and R2D are equal opportunity employers who do not discriminate in hiring promotion discharge pay, fringe benefits and other aspects of employment on the basis of race color, religion sex or national origin. With the new facility, equipment and anticipated growth the companies will fill all openings with qualified individuals regardless of race, color, religion, sex or national origin 19. The Equipment has not been installed as of the date of filing of this petition. (The signature at the end of this Petition is verification of this statement) (Revised 8/2/02) 4 20. The standard Industrial Classification Manual major group within which the proposed project would be classified, by number and description: ERL - 541700 - Scientific Research and Development Services. R21) - 6214510 - Medical and Diagnostic Laboratories 21. The Internal Revenue Service Code of Principal Business Activity by which the proposed project would be classified, by number and description: Same as #20 22. The real property where the Equipment will be installed is located in the following Allocation Area, if any, declared and confirmed by the South Bend Redevelopment Commission: Airport Economic Development Area 23. Other anticipated public financing for the project including, if any, industrial revenue - bonding to be sought or already authorized, assistance through the United States Department of Housing and Urban Development funds from the City of South Bend, Small Business Association Sections 503 and 504 financing through the Business Development Corporation of South Bend, Mishawaka, and St. Joseph County, Indiana; or other public financial assistance, including but not limited to public works improvements. N/A 24. Describe how and why the manufacturing equipment to be replaced or the facility in which Equipment will be added is currently technologically, economically or energy obsolete and how and why that obsolescence may lead to a decline in employment and tax revenues: No equipment is being replaced. All new equipment will be used for expansion of operations. The building is not designed for the needs of ERL and R21). The building is being partially rehabilitate to build rooms for the necessary laboratories to be utilized. Drawings are attached. (Revised 8/2/02) 5 25. The new manufacturing equipment will be used in the direct production, manufacture, fabrication, assembly, extraction, mining, processing, refining, or finishing of other tangible personal property and that the equipment was never before used by its owner for any purpose in Indiana. The signature at the end of this Petition is verification of this statement. 26. The following person(s) should be contacted as Petitioner' s agent regarding additional information and public hearing notifications: Name: Jeffrey M. McGowan, CPA and /or Renee M. Haves, EA Address: 210 S. Michigan St., Suite 200 City, State, Zip Code: South Bend IN 46601 Telephone: 574- 289 -4011 WHEREFORE, Petitioner requests that the Common Council of the City of South Bend, Indiana; adopt a declaratory resolution designating the area described herein to be an economic revitalization area for purposes of tangible personal property tax abatement consideration, and after publication of notice and public hearing, determine qualifications for an economic revitalization area have been met, and confirm such resolution. Petitioner herein hereby verifies that the required $250.00 filing fee to cover processing and administrative costs pursuant to Section 2 -84.7 of the Municipal Code of the City of South Bend has been paid in full. Name of Property Owner(s): M,zk gr, l 3 Mo��t> By: -- ( gned Name r pridted name "and capacity of sigdor if an agent or representative of the owner) Filed In ;,,G 011ice (Revised 8/2/02) 6 BORN VOORDE CITY CLERK, 50 BEND, 114- Attachment to: City of South Bend Petition for Tangible Personal Property Tax Abatement Consideration Exhibit A: Legal Description E PT Lot 25 Airport Industrial Park Phase II — Sec 33 —38 — 2E Cont .40 acres +/- W 287 FT of Lot 25 Airport Industrial Park Phase 1I — S.W.1 — 4 Sec 33 —38 — 2E 1.57 acres S 80.5 FT of Lot 24 S.W. 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' vere 6ry .E Grubby Ells® CEressytt & Yn15M11nnk Property Solution Worldwide &` 6loWAlliarce i EXHIBIT D ENZYME RESEARCH LABORATORIES 5 year Personal Property Abatement Schedule Total Estimated Equipment Cost: $ 800,000 Assume Constant rate of: 4.6250% (Based on 2004 rate) 100% Year TTV TTV% (Year1 -5) Assessed Value Tax Rate Tax Abated Tax Paid 1 40% 320,000 320,000 $ 14,800 $ 14,800 $ - 100% 2 56% 448,000 448,000 $ 20,720 $ 11,840 $ 8,880 80% 3 42% 336,000 336,000 $ 15,540 $ 8,880 $ 6,660 60% 4 32% 256,000 256,000 $ 11,840 $ 5,920 $ 5,920 40% 5 24% 192,000 192,000 $ 8,880 $ 2,960 $ 5,920 20% $ 71,780 $ 44,400 $ 27,380 Without Abatement: $ 71,780 With Abatement: $ 27,380 Amount Abated: $ 44,400 �('§ olffice Fil ed In DEC 1 9 2D6 JOHNVSOpBE D IN. CIN CLERK, Page 1 08/02/2005 00:25 2192894087 POWER OF ATTORNEY State Farm 23261 (R6 12.03) Prescribed by the Depsnment of _owl Government Finance Please TYPE or PRINT. KRUGGEL, LAWTON & CO PAGE 02 PART I - POWER OF ATTORNEY 1. Tax er IMonnIon yor must sl n and date this form on page 2' Ine 7 and have form notarized on page 2 fine 8. axpayer name a en • ;; p;) - Soclal security number Telephohe number 113- 56-3563 Michael J. Monts Employer identRcarlon number Enzyme Research Laboratories. Inc.. 412 S. Lafayette Street South Sand IN 48001 S 35-1661686 Dayd" telephone number - 574 280-2266 Hereby annoint(sl the followina renresentative(sh as attornev(sl -in -fact 2. Re esenfative Infottnaton (representative must sign and date this 7w 'on e 2 Patt Tax Form Number 1JM 131,133177, etc. If. Nenla eno sd less Telephohe number Jeffrey M. Mcpowan, CPA - _ 210 S. MICNgan Street, Suite 200 - South Berl IN 40001 (574) 2864011 - FAX number (574) 269.4087 Check k: C 40t7 El c4nk +i o ❑ New Address ❑ New Telephone Number name ana address - - - - e a ne number Renee M. Hayes, EA 210 S. Mich" Street, War 200 South Bend IN 48801 574 209 -4011 FAX number (574) 209 -4007 Check a: 6. RetentionfRevocadon of Prior Power(s) of Attorney: The filing of this power of attorney automatically revokes all earlier power(s) of attomey with the County Property Tax Assessment Board of Appeals. Department of Local Government Finance, or Indiana Board of Tax Review for the same tax matters and years or periods covered by this document. If you do not want to revoke a prior power of adomey, check this box .............. B ❑ /rr� Ay� r h r„g: i6iG. You must attach a copy of any power of attorney you wish to remain in effect. �l�8 ti'1 ��e3•�$ ❑New Address ON"TalaphoneNumber to represent the taxpayer(s), for the following matters, before the: 1� ® Deparanent of Local Govemmem Finance 0 J i EPt4 County Property Tax Assessment Board of Appeals Ondlano Board of Tax Rayiew S. Tax Matters Ty of Tex ratl ro ersonal ro Tax Form Number 1JM 131,133177, etc. YME(sj or Perlod s Rest and personal pmpony Abatement 12. CRA — RV o 3X2 EX& 2005 — .t C 40t7 El c4nk +i o 4. Acts Atdhorized: The representatives are authorized to receive and inspect confidential tax Information and to perform any and all acts that I (we) can perfMn with respect to the tax matters described in line 3, inducing the authority, to sign any agreaments, oonseMe or other documents. LIM any specific SOMM s or deletions to the acts otharwhee ouewrlred In this powerof attar ay 5. Notices and Communications: Notices and other communications will be sent to the first representative listed in line 2. If you also want the second representative listed to receive such notices and communications, check this box ............... ......... ^" m 6. RetentionfRevocadon of Prior Power(s) of Attorney: The filing of this power of attorney automatically revokes all earlier power(s) of attomey with the County Property Tax Assessment Board of Appeals. Department of Local Government Finance, or Indiana Board of Tax Review for the same tax matters and years or periods covered by this document. If you do not want to revoke a prior power of adomey, check this box .............. B ❑ /rr� Ay� r h r„g: i6iG. You must attach a copy of any power of attorney you wish to remain in effect. �l�8 ti'1 ��e3•�$ Continued on rover so side .1GHN VOORDE _ 08/02/2005 00:25 2192894087 KRUGGEL, LAWTON & CO PAGE 03 7. Signature of Taxpayer: If signed by a corporate officer, partner, guardian, tax matters partner /person, executor, receiver, administrator or trustee on behalf of the taxpayer, I certify that 1 have the authority to execute this form . on behalf of the taxpayer. the following applies If the autborfred representative Is a Cerdfled Ptopeol y Tax Representative pursuant to 50 IAc 15 -5.5: I understand that by authorizing JafBey M. McGowan _ as my Certified Property Tax Representative, I am aware of and accept the possibility that the property value may increase as a result of filing an administrative appeal with the Property Tax Assessment Board of Appeals, and that I may be compelled to appear at a hearing before the Property Tax Assessment Board of Appeals or the Department of Local Government Finance. I further understand that the Certified Property Tax Representative is not an attorney and may not present arguments of a legal nature on my behalf. M this power of attorney is not signed, dated and notarized, it will be returned. 819 ^�r Y s i e (.. epP roe e t - r v f Pr aklem Ph h! name of to yen - - _ Deto Michael J. Morris - ps-i9^cd 0-- Tana re of tegraYer e (I OPP ce c P&ted name of nexpayer - Date signed - S. Acknowl ant STATE OF Z tl(�, i (X(N l COUNTY OF S'f' — Z Q eQ.t- r t 55: n� Before me, a notary public in and for said state and county, personally appeared, this a day of 611 & i �.JlJO 5 the taxpsyer(s) or a person duly authorized to sign for and on behalf of the taxpayer(a), who acknowledged the execulion of this Power of atton ry o the voluntary act and deed of the taxpeyer(s). 5 eee ur Notary , 1 A- VCC county of residence 54 - O TYped orprintcd name of tblery Dale commission a irea S -Ve \ v O be✓ t t - r v f OR ENROLLMENT CARD NO. LJ - R - CLARATION OF REPRESE A Under Wairdi s of perjury. I declare that: I am were of the statutes, rules and regulations applicable to the matters specified In line 3: 1 am authorized to represent the taxpayer(s) identified in Part I for the tax matter(s) specified there: and I am one of the following: a. Certified Public Accountant - duly qualified to practice as a certified public accountant in the jurisdiction shown below. b. Cartlfled Tax Representative pursuant to 501AC iS5. c. Other (specify) If this declaration of representative is not signed and dated, the power of attorney will he returned. DESIGNATION JURISDICTION (slari% etc.) (Insertabove letter - a, b, or c) OR ENROLLMENT CARD NO. SIGNATURE DATE ((�� {•y a 0 - Enrolled Aum IN J -n m O MR, 10 0 jNi �N O O O N p (O (O CO N p0 L _o W (0n V jo 00 z N —1 A 0 co W O (0 0 N A Op W N N O 00 O N O N m (:1 z m o gay 0 0 � 0o A A A N A N N O C'9 N Of O W N O 00 m O MR, 10 0 jNi �N O O O N p (O (O CO N p0 o.i w W (0n V jo 00 N —1 A co W O (0 0 N A N N O 00 O N O N � 0o A A A N A N N O N Of O W N O 00 000 co W CI W W m co W A (Y> co co N -+ coi W co 00 01 N 00 CO 0i 1 0 (D Ai i �� 0� I V to 0 N'' ICI' IA 00 00 W T CO CO O W ((nj '0) W v a): IIW iw W N wl v N m O MR,