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STATEMENT OF BENEFITS
<br />PERSONAL PROPERTY
<br />State.Airm 59784'(1 2/12 -11.)
<br />. Pre:;crtlied. tiy'tile �epar)mlent of Local 0ot/emtrietit Shance
<br />.FORM SB4 t PP
<br />,PRIVACY NOTICE
<br />71te � §tend�nY.spec�l[c(ndniKlllal's
<br />salary informatiop is co
<br />c §'oftlie- nfldeniial; the
<br />balaitt(Ift1g'is ptiblfp record
<br />11VSTRUi;T10(VS: per]C'S 1.-12.1 =5.1 c and
<br />(d).
<br />i, Ttrls statgrtiaitt tnus! ba sriblrfitteil to 'the body,desfgnatfng the Economic Revitalizatfan Ares r to ihei puhlic.hear)ng.if the designating body regrllres
<br />infonnalloh frbM the applicant 1ti itraklriy its decisfop abgyt ether to. desigfiafe an'Ec;inomic ReviltalizatlanOrea: Othetwlse fhf§ statetfientinirstGe subtriftted
<br />to fhe designating.body BL�FORI; a p i pe insfails tine ne,W maqulactvring egtipment and/orresearch and develnp/neirt equlpm nt, •andlbrld sfi6i11 dis %r96utfoli
<br />equipmen! grid /orfnforil3aGonechiiolpgy equlpmepf for yvhlch iho' .arson wishes to claim a deduction: "ProJeet¢ "planned br cdmritltfed to alter duly ), 998?•,
<br />and aye s designated afi6r July'11 9987, raga }re. a STA79; I-fENf t F BE(VEFiT.S. (IC ��, f -12.1)
<br />2. Approival of fhe desonaffng b6gy (oily Council, rowp•Board County Council, etc.) must be obtained "riot to installation of the nbl* manirfaaturing equipment
<br />bred /or research a►id developmeirt egulpmen[ andlorlogistfcaf disfdbufron equ/pnienf enrl/orfnformat
<br />be apptbved n technology equipment, BEFORE a #eVt dfio »may
<br />3 To•obiain a deduction, a person mrlstflle age
<br />r&igl d- deductioi7,sciidd4le -with the.perso'n's persbhel prgpeiigfetum on-a ceAified dedudtrop scliedufe.(l =prm
<br />io&ER/t) 'wph fhs lowrishfp essesadr bf the township where the propetly. k situated pr 0111 the ooui�ty:assesagr d there Is nb MW4zhip o'ssesiior tol4be
<br />foivrislilp. The' 03 ERAmust be fhnq bejii+eep March f andf May 18 at'the assessment year in which newmanurrf�attating equipment and /orresearch and
<br />develdptrrent eggfp h'. d/o "r logistical 0"t,46n equipment and7or Infor/rladdh technology egypinebt Is installed and folly h nctibn�al, t►nless a filing
<br />606hsieh has 00 0140414: A person Who Waihs a riling exteneoh 't4ust'filb the" form •betwaen March 9 .anti fhd exfehded 'due date bf brat year
<br />4. Property o'ivners Wfipse Statement,of Betiefltd was approved after June 30 1991,.rrust4,ubrr Form CF l % PP annually fp sljgt+Y 6omplfance with
<br />the
<br />�Sidtemehl ofBenefils. (iC,6: 9.1 -12. x:5.6)
<br />5. The schedulee established- uhder]c 64.142_9 -4.5(d) and (e) apply 6 equipmentfristalled afterM0rch 9,.21101, unless an alternative deducfion sahe_dgle Is
<br />mdopted by the deslgna Jfig booty (/C ¢-i, ,1- 92.9 -97).
<br />Co., Inc.
<br />Rame of contact persod
<br />Herb Eggers
<br />Name of designating body
<br />City of South Bend Rasoiullon number (s)
<br />Lo6don•cf property County DLGF iaxin
<br />1619 81623 Franklin St., South Bend, IN 46613 eE ��Ce�ti g dishict number
<br />andwonat sp ets it ngcessary) START DATE. I COMPLE'
<br />Manufacturinggiilpmant 3/15/2016 12/15/2017
<br />R & D Egyipti Ent
<br />Lathes, Wlre EDM, Automatic Band Saw, Auto CMM, TooAng, Warehouse Rocking, PCs, ERP Software
<br />Ldgist we FgL#pm- -fit 7/15/2016 11115/2018
<br />IT Egygp.me t. 7/15/2016 10/31/2017
<br />number ISatadnensn II1umbarret$trw 4 �SaA�rie Numtieradd&Ional
<br />$378.560
<br />SECTION 4 ESTMIATED
<br />TOTAL COST AND VALUE OF PROPOSED PROJECT
<br />NOTE., Pursutntlodr; 6- 1.1- 12,1-5.1 d 2 the
<br />() �. ? _
<br />MANUFACTtiFtING R 8� D EQUIPMENT I- 06!_'71305#'
<br />EQUIPMENT - IT EQUIPMENT
<br />EQUIBN(ENT
<br />COST bf thi= 0Poperty is confideiitlai.
<br />GbsY
<br />ASSESSED COST' _ COST A3SI =SSED COSTvAELUD
<br />VALUE. VALt
<br />Ctirrp8t ?ratite's.
<br />VALUE
<br />Pitrs .estimatetivatriesofproposed .protect
<br />;esz3,on.
<br />�sz3,o77 $11,305 0 S9,300 0
<br />y prop. 4113eing replaced
<br />[ass 4a11Ies or ±4
<br />Net esltn7Hled>r! Ei( tJPST1po rTCOrr1.1e1jOn.pltprofeC(.-
<br />5623.077
<br />$623,077. $11305 An'
<br />o
<br />SECTION 5 =STE CONVERTED
<br />AND
<br />OTHER BENEFiTS PROMISED BY THE TAXPAYER
<br />Es0rna(e4 solid wasteppfjyerted
<br />l sltrriated hazardous,Wade converted (pounds)
<br />I hereby certify Ihat the represenlaQons in this statement are tare:
<br />Sign... I' dFat.0911 e;l, "ropresentaWe �, y� ggRa8yalgneabylryleHaibbon Titfe Dete..stgned (Month. day', yea ?)
<br />Date,* 2016,09.8911 ;996. MY Project Manager 03/0312016
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