Laserfiche WebLink
STATEMENT OF BENEFITS <br />PERSONAL PROPERTY <br />Stale Form 51764 (R2112 -11) <br />Prescribed by the Department of Local Government Finance <br />JOb1t1€ y100*;DE <br />CITY CLERK, SOUTH ,SEND, IN <br />FORM SS -1 /Pp <br />PRIVACY NOTICE <br />The costendany ar2-ci TOduafs <br />salary infomlelion is oinfidenliai; the <br />balance of the fill g is pubic record <br />INSTRUCTIONS. r IC 6 -1.1. 12.1.5.1 (c) eod (d), <br />1. Th/s 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,whetherto designate an Economic Revitalization Area. Otherwise this statement must be submitted <br />to the designating body BEFORE a person installs the new manufacturing equipment and/or research and development equipment, andforlogistical distribution <br />equipment and/orhub mation technology equipment for which the person wishes to claim a deduction. Projects "planned or commkted io afteiJUly 1, ig87, <br />and areas designated after July 1, 1987, require a STATEMENTOFBENEFITS. (IC6- 1.1-12.1) <br />2. Approval of (he designating body (Co Council, Tom Board, County Council, etc.) must be obtained poor to installation of the new manufacturing equipment <br />and/or research and development equipment and/or logistikal distribution equipment and/or information technology equipment BEFORE a deduction may <br />be approved <br />3. To obtain a deduction, a person must file a certified deduction schedule with the person's personal property return on a certified deduction schedule (Form <br />103 -ERA) with the township assessor of the township where the property is situated or with the county assessor if there is no township assessor for the <br />township. The 103 -ER4 must be filed between March land May 15 ofthe assessment year in which new manufacturing equipment and/or research and <br />development equipment and/or logistical distribution equipment and/or information technology equipment is installed and fully functional, unless a filing <br />extension has been obtained. A person who obtains a filing extension must file the form between March i end the extended due date of that year. <br />4. Property owners whose Statement of Benefits was approved after June 30, 1991, must submit Form CF -1 / PP annually to show compliance with the <br />Statemem ofBenefits. (IC 6 -1.1- 12,1 -5.6) <br />5. The schedules established under IC 6.1.1.12.1.4.5(d) and (e) apply to equipment installed after Match 1, 2001, unless an alternative deduction schedule is <br />adopted by the designating body (1C 6 -1.1. 12.1 -17), <br />SECTION INFORMATION <br />Name of taxpayer <br />6amar Plasllw. Inc. <br />Address of Msah Siers<mu 8 iN SM city, stale, and ZIP cods) <br />1]02 5. Robin o e <br />Name of contact person <br />Tncis Blair <br />Telephone. number <br />570.2341(366 <br />• • • • I • • •••• • ••• <br />Name of designating body <br />ResoiUdon number (s) <br />Location of property <br />1702 S. Robinson St. South Bend, IN 46613 <br />Cauni <br />DLGF taxing district number <br />SL Joseph <br />Description of manufacturing equipment and/or research and development equipment <br />and/or logistical distribution equipment and/or information technology equipment. <br />ESTIMATED <br />START DATE <br />COMPLETION DATE <br />(use additional sheets if necessary) <br />001612015 <br />nmtrzol5 <br />Manufacturing Equipment <br />R & D Equipment <br />Rotary Table Ventral press. Water Towers (2), Auxiliary Equipment, Vision System, Computers, Servers. Firewall 8 <br />Logisl Dist Equipment <br />IT Equipment <br />05f0112015 <br />11/0112(315 <br />Currentnumber Salaries Number retained Salaries Number additional <br />32 $1,045,408 <br />32 $1.045,408 <br />$5 000- $15,000 <br />NOTE: Pursuant to ICB -1.1- 12.9 -5.1 (d) (2) the MANUFACTURING R & D EQUIPMENT LOGIST DIST <br />EQUIPMENT <br />IT EQUIPMENT <br />EQUIPMENT <br />COST of the property is confidential. COST ASSESSED COST ASSESSED ASSESSED <br />COST <br />WILLIE VALUE <br />COST <br />ASSESSED <br />Vi1LUE <br />Current values <br />$o <br />Plus estimated values of proposed project <br />$3s4o(3o <br />515,000 <br />Lass values of any property being replaced <br />Net estimated values upon completion of project <br />,coo <br />sls,000 <br />• • • . . • <br />.. <br />Estimated solid waste converted (pounds) No <br />Estimated hazardous waste converted (pounds) we <br />Other benefils: <br />SECTION 6 TAXPAYER CERTIFICATION <br />i hereby certify that the representations in this statement are We. <br />Sig otelAtlonzed repro a Tl6e <br />Date sig (month, day, year) <br />a i- <br />Page 1 of 2 119 %rJl[42a-Q{�y° <br />