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STATEMENT OF BENEFITS <br />REAL ESTATE IMPROVEMENTS <br />State Form 51767 (R412 -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- 12.14.1) <br />fNSIKUGIIVNS. <br />1. 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 properly for which the person wishes to claim a deduction. <br />Projects-planned or committed to after July 1. 1987, and areas designated after July 1, 1987, require a STATEMENT OF BENEFITS. (IC 6 -1.1 -12.1) <br />2. Approval of the designating body (City Council, Town Board, County Council, etc.) must be obtained prior to initiation of the redevelopment or <br />rehabilitation, BEFORE deduction maybe appro ved. <br />3. To obtain a deduction, a Form 3221RE must be filed with the County Audftor before May 10 in the year in which the addition to assessed valuation is <br />made or not later than thirty (30) days afterthe assessment notice is mailed to the property owner if it was mailed after April 10. If the property owner <br />misses the May 10 deadline in the initial year of occupation, he can apply between March 1 and May 10 of a subsequent year. <br />4. Property owners whose Statement of Benefits was approved after June 30, 1991, must attach a Form CF- IlReal Property annually to the application to <br />show compliance with the Statement of Benefits. PC 6- 1.1- 12.1.5.1(b) and 1Cfi -1.1- 12.1- 5.3Q)J. <br />5. The schedules established under IC 6- 1.1- 12.1-4(d) for rehabilitated property apply to any economic re vitalization areas designated after June 30. 2000, <br />unless an aftemative deduction schedule is adopted by the designating body (IC 6.1.1- 12.1 -17). The schedules effective pdorto July 1, 2000, shall <br />continue to apply to economic revitalization areas designated before July 1. 2000. <br />• <br />•- <br />Name of taxpayer <br />Ameriplex Superior Partners, L.P. <br />Address of taxpayer (number and street city, state, and ZIPCode) <br />227 S. Main Street Suite 200 South Bend, IN 46601 <br />Name of contact person <br />Telephone number <br />E -mail address <br />Manette Tape <br />$74- 2i74�05 <br />mtepe @holladaypropentes.com <br />' <br />Name of designating body <br />City of South Bend <br />Resolution number <br />Location of property <br />County <br />5231 Dylan Dnve, South Bend, IN <br />SL Joseph <br />DLGF taxing district number <br />Description of real property improvements, redevelopment t orrehabililaGOn fuse addib'onalsheets if necessary) <br />Estimated start dale (month, day. yean <br />May2015 <br />The existing building will receive an addition of 60,770sf. <br />Estimated completion dale (month, day, year) <br />August 2015 <br />'- • - • <br />`Salaries <br />1 1 <br />Current number <br />Number retained <br />Salaries Number additional Salaries <br />62 $2,086,220 <br />62 <br />$2,086,220 12 $025.000 <br />t <br />REAL ESTATE IMPROVEMENTS <br />COST <br />ASSESSED VALUE <br />Current values <br />$3,500,000 <br />$3,253,100 <br />Plus estimated values of proposed pro ect <br />$2,100,000 <br />$1.500.000 <br />Less values of any property being replaced <br />Net estimated values upon completion of project <br />$5,600,000 <br />$4,753,100 <br />Estimated solid waste converted (pounds) <br />Estimated hazer F"Od" rted { pounds .V <br />Other benefits <br />) <br />CITY CLERri%'jSOW H, BEND, IN <br />SECTION 6 TAXPAYER <br />CERTIFICATION <br />I he b certify t e representations in this statement are true. <br />Signature f a h r resentaltve <br />Title ^ <br />Date signed (month, day, yead <br />- r <br />Page 1 of 2 <br />