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Filed ,� I4fice
<br />r ORSTATEMENT OF BENEFITS FORM SB -1 I PP
<br />PERSONAL PROPERTY q ! l _.. State Form 61764 (RJ/12 -t J) tM2 G.015 Prescribed by the Department of Local Government F ante _ sz PRIVACY NOTICE
<br />Nry norrneomr r.o u nr nn
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<br />JQT :. + nl Inn rnpony and N•lare I y
<br />-[:" to euavldval mnitoyoas bV ... ry.. enY
<br />CITY CLERK, � a },dElt?Dr IN doom is ronmlemn,l pvl II; m I t w rli I
<br />INSTRUCTIONS -- - - -- — -
<br />Y. 71tls slatanlnpf meal he Still roillot/ to the body dungnpting rile Eeonnmic Revdnf iotion Alen prim In Ilia public hennng it Ilia dosignalerg body requires
<br />bnnnnnlmn Iron the apparnrrl in ntpaur9 its dace:..... about whrlhar to rhrslg +Iola un Fconarnk liovnnllznlion Aran Olhensdse Iles sbdemenf meat be
<br />m tin lll0d to the deslgualing hr Kly BEFORE n I.....on ....Will I/m noly mn I'docrunirg aquipmeaf alef /ar rasrmch and development er/ulpmenf, and(or
<br />1...111( /[en 01VIIbulion vlodpnrenl andlcr inforr.moo incline logy uqu4unenl for whirl, Iho im,s n wishes In choo, n dodl+clion.
<br />2. The statement of benefits torn must be submitted to the designating body and the area designated on economic revitalization area before the Installation
<br />of qualifying abeleble equipment for which the person desires to claim a deduction.
<br />1 Ili obildo a OcdurPon, n person mu:a Ali- a rmafied rlcrlu:-llon • tchedule wdn file person's parsolml prupm!y n.•hrrn all a celnhrd dcducadn srhedd /d
<br />it alln 103 Rol) with the (nrmslup a:•se. +sor or flip rmvnmq, who +o the properly is .hurtled or tI ilil the manly assessor if thmo rs all torvnShip essassw
<br />for Iho lowaship. lilt 103 1leA nwst fill 1,6d hrlwtron March I will May If, of file nssassrnent year In which new inanulaclumrq equipment
<br />and/or tu.sean:h and devetopnreni ngerprnenl nods, Icgrslrca/ dishlbulion oqulpnlem a rldRn mfoonatlon lochnulugy equlpmunl is installed and fully
<br />functinnp( unless a liter./ nvlanrann ha,s beer, ebfibood A ponww, who obtains to filing off, mn must life file loan bahveco Match I and Ibe exReWod
<br />due date of that year.
<br />4. Property owners whose Statement of Benefits was approved, must submit Form CF -1oFP annually to show compliance with the Statement of Benefits
<br />pc
<br />S. fore Form 584rPP that Is approved aderJune 30, 2013, the designating body Is required to establish an abatement schedule foreach deduction a /lowed.
<br />Fore Form SB4rPP that is approved pdorto July 1, 2013, me abatement schedule approved by the designating body remains In effect. (IC 6-1.1- 12.1.17)
<br />SECTION
<br />•-
<br />Name of ta•peyer
<br />Name, of contact person
<br />Harems Kulzer, LLC
<br />--
<br />Kira Galas, Director of Finance
<br />._.__._._. _..._..- sr - -- -- ---- -
<br />ndJrns•mbepayer(nmm�nr and street. Nly, sPole, and ZIP Code)
<br />_
<br />— -- --._-' - - ---
<br />7sNpnwre numb•I
<br />300 Heraeus Way, South Bend, IN 46614 -2517
<br />( 574 ) 299.5401
<br />SECTION2 LOCATION
<br />OF -r -.
<br />Name or dan"nnling body
<br />Rasolution wmbnr (s)
<br />City of South Bend
<br />Location Mproperty
<br />county ,
<br />DICp Ie•Ina di.irid nunioor
<br />300 Heraeus Way, South Bend, IN 46614 -2517
<br />ST JOSEPH
<br />_ . --
<br />Q I i .�
<br />_ —
<br />Ud:;rripunn of mnnufnc(udn0 ogwpwnnl dudon manna -n and drvvlopolvni equnnnonl
<br />ESTIMATEIJ_
<br />.wdlo' InginimM dishlhtdiall &tinpmunl and+nr Inlolmabnn teclmoWgy equipment
<br />Il/ar uddllonal s /a•rts it naarssatYJ
<br />- --
<br />ON START DATE COMPLETION
<br />—_ G
<br />-- START - ON DA
<br />r rqup,mnnt Scanners for digitized dentistry products and IT Hardware for R&D lab Manufacturing Equipment
<br />R i D Equipment
<br />Loglst Dist Equipment
<br />-_ - -- -- -
<br />IT Equipment
<br />02101ROIS 121312017
<br />SECTION OF • AND SALARIES
<br />AS RESULT OF ••• a PROJECT
<br />tortoni number Sulanos Numow relsmod
<br />9olane> NVlilbnf adoledrwl Sohnlo•
<br />90 35,850,000 90
<br />$5,860,000 10 $520,000
<br />SECTION4 ESTIMATED TOTAL COST I
<br />VALUE OF •••• • PROJECT
<br />NOTE: Pursuant to IC 6 -1.1- 12.1.5.1 (d) (2) the
<br />MANUFACTURING
<br />EUl11P ENT
<br />R i D EQUIPMENT
<br />LOGIST DIST IT EQUIPMENT
<br />_ EQUIPMENT
<br />COST of the property Is confidential.
<br />COST n: "'LI' °`n
<br />COST ti;5E S8En
<br />_ _00 - ____. _
<br />COST A$Se:SSEO ST AIALU En
<br />VALUE
<br />\MLUE
<br />W.1 VALUE
<br />Current values —..
<br />._ _ —_. _.-
<br />__ --
<br />._.
<br />Plus estimated vasles of proposotl pro's,(
<br />_ 2,28_5,60_9 _ 914,244
<br />Less values of any propedy belpg_re laced
<br />_
<br />914.244
<br />Net estimated values upon complell nn of projma
<br />SECTION 5 WASTE CONVERTED AND OTHER BENEFITS
<br />PROMISED BY TI
<br />Estimated solid waste converted (pounds)
<br />Estimated hazardous waste oonveded (pounds)
<br />SFCTIONC, TAXPAYER CERTIFICATION
<br />I hereby asQfly Wit 11 pre Italians; In this statement are tNe.
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