05-26-15 Agenda, Packet & Committee Meeting Notice

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STATEMENT OF BENEFITS REAL ESTATE IMPROVEMENTS State Form 51767 (RS i 10 -14) ° - Prescribed by the Department of Local Government Finance This statement is being completed for real property that qualifies under the following Indiana Code (check one box): L] Redevelopment or rehabilitation of real estate improvements (IC 6 -1.1- 12.1 -4) ❑ Residentially distressed area (IC 6 -11- 12.1 -41) 20_ PAY 20_ FORM SBA I Real Property PRIVACY NOTICE Any information concerning the cost of the property and speck salaries paid to Individual employees by the property owner is confidential per IC 6 -1.1- 12.1 -5.1. INSTRUCTIONS: 1. This statement must be submitted to the body designating the Economic Revitalization Area prior to the public hearing if the designating body requires information from the applicant in making its decision about whetherlo designate an Economic Revitalization Area. Otherwise, this statement must be submitted to the designating body BEFORE the redevelopment orrehabilitation of rea /property for which the person wishes to claim a deduction. 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 the redevelopment or rehabilitation for which the person desires to claim a deduction. 3. To obtain a deduction, a Form 3221RE must be filed with the County A uditor before May 10 in the year In which the addition to assessed valuation is made or not later than thirty (30) days after the assessment notice is mailed to the property ownerif it was mailed afterApol 10. A property owner who failed to file a deduction application within the prescribed deadline may file an application between March 1 and May 10 of a subsequent year. 4. A property owner who files for the deduction mustprovide the CountyAuditorand designating body with a Form CF- IlReal Property. The Form CFI /Real Property should be attached to the Form 3221RE when the deduction is first claimed and then updated annually for each year the deduction is applicable. tC 6 -1.1- 12.1- 5.1(b) 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 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 remains in effect 106 -1.1- 12.1 -17 SECTION I TAXPAYER INFORMATION Name of taxpayer f^� T�'` 7S UEVEL,OPMFiv7-j1 -. 1-5014THNOC,O, GLC Address of taxpayer (number andstmet, ciN state, and ZIPcode) 247 North Dixieway, South Bend, IN 46637 Name of contact person Telephone number E -mad address AJ Patel (574) 387 -4467 info @jskhotel.com SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT Name of designa0ng body Resolution number South Bend Common Council Location of property Ccunly DLGF taxing district number 121 St. Joseph St., South Bend, IN 46601 St. Joseph Descnption of real property improvements, redevelopment, or rehabilitation (use additional sheelsifnecessary) Estimated start data (month, day, year) Construction of 120 room hotel August 1, 2015 Estimated oomphation data (month, day, 0a4 March 1, 201.7 SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIESAS RESULTOF PROPOSED PROJECT Current number i Salaries iflumberretained i Salaries I Numner additional Caunne Pagel of 2