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STATEMENT OF BENEFITS <br />REAL ESTATE IMPROVEMENTS <br />State Form 51767 (R5112 -13) <br />® Prescribed by the Department of Local Government Finance <br />This statement is being completed for real property that qualifies under the following Indiana Code (check one box): <br />❑ Redevelopment or rehabilitation of real estate improvements (IC 6- 1.1- 12.1 -4) <br />❑ Residentially distressed area (IC 6- 1.1- 12.1 -4.1) <br />INSTRUCTIONS: <br />20_ PAY 20_ <br />FORM SB -1 I Real Property <br />PRIVACY NOTICE <br />Any information concerning the cost <br />of the property and specific salaries <br />paid to individual employyees by the <br />Property owner is co�tlential per <br />IC 6-1.1- 12.1 -5.1. <br />I. 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 the redevelopment or rehabilitation of real property 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 initiation of <br />the redevelopment or rehabilitation for which the person desires to claim a deduction. <br />3. To obtain a deduction, a Form 3221RE must be filed with the County Auditor before May 10 in the year in which the addition to assessed valuation is <br />made or not later than thirty (30) days after the assessment notice is mailed to the property owner Nit was mailed afterApol 10. A property owner who <br />failed to rile a deduction application within the prescribed deadline may file an application between March 1 and May f0 of a subsequent year <br />4. A property owner who files for the deduction must provide the County Auditor and designating body with a Form CF -1 /Real Property. The Form CF- 1/Real <br />Property should (b attached to the Form 3221RE when the deduction is first claimed and then updated annually for each year the deduction is applicable. <br />IC6 -1.1- 12.1- 5.1(b) <br />5. For a Form SB -1 /Real Property that is approved after June 30, 2013, the designating body is required to establish an abatement schedule for each <br />deduction allowed. For a Form SB- 1/Real Property that is approved prior to July 1, 2013, the abatement schedule approved by the designating body <br />remains in effect. IC 6.1.1- 12.1 -17 <br />SECTION 1 <br />TAXPAYER <br />Name of taxpayer <br />INFORMATION <br />COOREMAN REAL ESTATE GROUP INC. <br />Address of taxpayer (number and street, city, stab, and ZIP code) <br />4404 TECHNOLOGY DRIVE <br />Name of contact person <br />Telephone number <br />E -mail address <br />STEPHANIE WEBSTER <br />( 574 ) 277 -0116 <br />ste hanie cooreman.com <br />Name of designating body <br />SOUTH BEND COMMON COUNCIL <br />Resolution number <br />Location of property <br />4295 -13 <br />N OF BRICK RD/ E OF ORANGE RD/ W OF US 31 BYPASS <br />County <br />ST. JOSEPH <br />DLGF taxing district number <br />GERMAN <br />Description of gal property improvemenLS, redevelopment, or rehabilitation (use additional sheets if necessary) <br />Estimated start date (month, dajyeao <br />Three (3) homes in the Villas at Lake Blackthorn Section I & Ik a single family home subdivision with a <br />11/12/2014 <br />total of 114 lots, located on 56 +/_ acres with a large lake, gazebo park, and small pond. Avg. home price <br />Estimated completion date (mo <br />$ 250,000.00, avg. lot price $47,000.00 <br />11/12/2019 <br />Current number Salaries Number retained <br />Salaries Number additional Salaries <br />REAL ESTATE IMPROVEMENTS <br />Current values <br />COST ASSESSED VALUE <br />Plus estimated values of proposed project <br />175 000.00 530.000.00 <br />12,750.000.00 <br />Less values of any property being replaced <br />12,750,000.00 <br />Net estimated values upon completion of project <br />15,150.000.00 15,150,000.00 <br />Estimated solid waste converted (pounds) <br />Estimated haz ardI�tari�rvetted({p`odrsdsf office <br />Other benefits <br />._ <br />014T <br />beti t <br />EITY` <br />rti t the representations in this statement are true. <br />w presentative <br />7Printednameifaynoraed <br />Date $igne�(m nth, d y, year) <br />C <br />representative <br />7 M <br />Tide <br />STEVE CO OREMAN <br />PRESIDENT <br />Page 1 of 2 <br />