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STATEMENT OF BENEFITS <br />REAL tSTATE IMPROVEMENTS <br />Form 51767 (RO 110- 14) <br />crIbed by the D <br />apairiment of Local Government Finanpe <br />This statement is being completed for real property that qualifles.under the follovilrig Indiana Code:(dhavk- <br />Redevelopment or rahabilitotion of real estate improvements (Ic 6-1.1-12,14) <br />Cl Rgsidentially distressed area (IC 6-14-12.14A) <br />2 — <br />o7PAY 2o <br />L _17 <br />FORM S3-1 I Roal Pro porty <br />PRIVACY NOTICE <br />Any Informollon concernIno the Z3z7l_ <br />of the. progri <br />.1 and;speelfic salaries <br />L <br />pid to In IV! ual 6rnplayaes by the <br />rit Owner Is conlid.ehilio per <br />CT01Y 12.1-5.1. — <br />779sMaydniOnt 00-91 he s4inifted to the body designating <br />0ahn'411 fhe designaling body-mquIres <br />infirmalibii k6m the ap.01cantin maknig its recision AboiPt vehaffierto designate an Economic RaOiiidiation Area. c7fhenvise, this sFatrt mart must be <br />sr,binitlt?al to tl�e designating body B�FtiR� the redevetopment:vrrehabflitation of rural property for which the parson wib>~ies to claim a dedt+olion. <br />Z The statenierit of benefits form most be submitted to the des4nating body and the area dBSijnafad an economic ravilalization area before Me WItation of <br />the'redeve1pprnerrt or A-habithalibri. for i0ich the person offs1res to claira 6 deduction. <br />To a.b.1alr? a deduction, a. Form , 322/RE most be filed with the CountyAbdiforbafarb May 10 in the year h? which the addition to assessed valuation . is <br />IM206 br nbt later than thirfy PO) days afterthe assessment notice is rballad to the prvoerty owner if it v,,# m0ed afterApril 10. Apmpe46weri0o <br />railed tc '6?0 a decWkon app),itation k0hir? the prescfibed dead&w may file an applIcation haiwean March 1. and May 10 of 6. subsequent yea;;. <br />, . .. 1. . . <br />Aii. .1 prcpady, owner wh'a - files for the deduction must provide the CourilkAddirar and das?gnat1h9 b6dy ift a Form CF-14�?aal Property. -The Foah CF-lAdal <br />Pipperty ihoirld bia.attached to lire Rome 322ME't�6a�i the deduc#011 is first ati2imed Qnd Men irpidated annually for each yearthe deduction is applica . ble. <br />1C.6- 1;1 -v2 !z. q ) <br />For a Foriii S150IRaaf -propedy that Is approved after June 16, 2013,. the dasignagnq body is required to establish an'96alement wh edule for each <br />ducluction. iillbwed. For a Fomi SEL11FIffal Pffipe)ly that Is appmvad prior to J14y I" jOIZ. fhe abatement schedule eapproved by the de.0grialihiII both <br />remains. in effect. tC ti -1. ?- 72.9 -17 <br />8FCTION I WOAVEK' <br />I'NFORMATION <br />Name of taxpayer <br />The Leb ermuth Company, Inc. <br />Add(ess'aft"ycit(numperandsties4 city stale, and0PmxL-) <br />4004 Technology Drive, South Bend, IN 46628 <br />Name of cont2m -F-e—r3on <br />Telephone number <br />E -mQ address <br />Mark Slhqlaft° <br />1( 574 ) 259-7000 <br />mark. sinclair@leb6rtnuth.corn <br />SECTION 2 LOCATION AND DESCRIPTION <br />OF PROPOSED PROJECT <br />Resolution number <br />rCity of South Send, City Council <br />Location of property <br />County <br />E)LGF fivIng dIstric] number <br />4004 TeChnology De�ve, South Bend, IN 46628 <br />ST JOSEPH <br />009 <br />ReWPIfem Of feel property impruvemBritsi redevelopmerk or rehabIlliabon fuse eddijonq) <br />sneels irpermaW <br />Eaftated 414M dole (Moni%i, dw Year) <br />aijil Ing impro" <br />..d merits with additional 9;000 sf to house automated Concordia product line <br />May is, 2016 <br />EsllmBled compWAn date.(month, dox yu <br />December 31, 2016 <br />SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES <br />AS RESULT OF PROPOSED PROJECT <br />Current number Salatles Number WaIncd <br />Salanrs Number 3ddj50—ns7— sawe-, <br />70,00 $3,916,640.00 170.00 <br />1 $3,916,640.00 5.00 U08'000'00 <br />SECTION 4 Es'rimArr=D TOTAL COST AND <br />VALUE OF PROPOSED PROJECT <br />REAL ESTATE IMPROVEMENTS <br />COST ASSMED VALUE <br />Current values <br />Plus estimated Values of Iqpused project <br />225,000.00 .000.00 <br />225,0001.00 <br />Less-values ofarrij property being replaced <br />Net estimated values upon COMP113110n of Pfl)]Wt <br />221000.00 <br />225,000.00 <br />SECTION 5 WASTE CONVI�RTED AND OTHER <br />13ENEFITS PROMISEII 13Y T'HE TAXPAYER — <br />Estimated salid waste converted (pounds) <br />Estimated hazardous wiste c <br />Other benerits <br />[ APR 2 0 2016 <br />KAREEMAH FOWLER <br />CITY CLERK, SOUTH BEND, IN I <br />SECTION 6 TAXPAYER CERTIFICATION <br />.1, hereby Partify 1hat the representations in this statement are true, <br />Porlalure oF authorized representsNe^ <br />yearj <br />Printed name Of authorized repraseritgvd. <br />Title* <br />Page 1 of <br />