Laserfiche WebLink
STA;TEMEN'� i]F BENEFITS <br />OEERSCNt4t� RRC R�Rjy <br />Sta4eFcrrr 5i7a4'tKV ii'.; <br />> 1 Prescr76sd by iha Deparimsnt of Local Govemment Finance <br />F>aRNi SB 1 f p?p <br />FWACY ROME <br />An�p'.�. intonnatton concerning the cost <br />of the property and speie fie salarles pold <br />to Individual mnployees by the praport <br />owner is confidanlial per IC 6-1.'1 - 12'11 -T. . <br />1N5TRucvofvs. <br />Y_ This staterrfeht must be submitted to the bbdy designating the Economic Favitaflzaf fon Area poor to the public hearing if the des4na hg _body 7egrriras <br />krA metfan from the applicant in making ils docfsion about yvhethar 10 4`06101016 an i=conomio Fevitatrzetida Area_ Omerwise this statement must be <br />submitted to the designating body BEFORE a person Installs the not r r»an.ul cJurrrig egvfpment and/or research and development equipment. and/or <br />logistical distribudon egrripmsrit anftrin6rm2tion lechnotagy equipment for which the peradn wishes to claim a deductfon. <br />2. The slatemanf of b6neflls ibrrrt inusl be subMittedlo the designating Uodyand the area designated an et6170m7c tevitaUzallon area before the . inalailotion <br />of qualifying abatable equiprnant for which the person desires to claim a deductfon. <br />3' To oblate a,deducton; f person must BIo`a cartified deduction schedule with fhe person's jQersonal property rehrm on.a certified - deduction schedule <br />(Fort 703 -ERA) with the township assassar of tha lownsttip tivheta t8e prpp6rYy is situated or iyiUl .the county assessgrif there is no toiinship assessor <br />for the tovinship. The 103 -EAA must be filed between ,lanuary 7 and May f b of the :assessment yaar In which new manufablurfng equipment <br />and/or research and deva)OpmQnt squlpment and/or log,stipai distribtrtiarr etlulpment angler information technology equipment `is hsWI d and fully <br />hmcdona), pnfeis a !!ling axtarrslon has bean obtained. 4 person who obtafns a oing eRtension. mustfrte The fonir between January i unit the extended <br />dua date of 2Jim year <br />+F. Prnpetfy ownars_whase Sfalamant bf 8onefils was approved, must submit Form CF• PP- aniivaJfyt0 shaNCOmplierrce wfth the Statement of 891101rls. <br />(tG'S-f. f= '72.1 -5.5j <br />For r Form SB- 7rpl'thatis.approvedaRerJune3p 2f1i3; thee' asigriatfhgbacfyisregoiredtdrstsbilshsn' abatementsehrdriteforeachdeducl7onaffowad. <br />Para Farm M -IAV that is approved prfor to July 1, 2013 litre abatementschr duk approved by the designating body remains in affect <br />-- <br />SEC�TION <br />ORMATION <br />Name of taxpayer <br />Name of contact persbn <br />The Lebermut]h Company, lrtc. <br />Mark Sinclair <br />Address of Taxpayer Mvmberaedstreeb ft,, sfafo; Bird &Pcod6) <br />( Telephone number <br />.4009 Technalbgy Drive, South Send, IN 46628. <br />4 674 ). 25977000 <br />LOCATION DIESCA110TIdA.-OF.PROO.OSED <br />PROJECT <br />Name of des?gnating body - -- - -- <br />Resolution number (s) <br />City of South Bend, .City Council <br />L,00ellon of prvperty <br />county <br />DLGF iaxing dlsidet number <br />4004 Technology Drive, South Bend, IN 46628 <br />STJOSEPH <br />009 <br />Description of manufacturing equipment andlar ressarch and development equlpr6ant <br />ESTIMATED <br />STA3IT DATE <br />COMPLETION DATE <br />and/or logistioal distribution equipment and/or information technology equipment. <br />((Ise additional sheets )f r?ecassary.) <br />Manufacturing Equipment <br />05115/2016 <br />1213112015 <br />M_anufaeturing Equipment vvith Fricke autornated filling product line <br />R S D Equipment <br />I <br />Wgisl Dist Equipment <br />IT Equipment _- - <br />- — <br />Current number Salerie5 NumherrewIned <br />Satarles Numberadd;tcnal SBlalle6 <br />70 $3,916,640 70 <br />$3,916,640 5 $208,000 <br />SECTION 4 ESTIMATED TOTAL COST AND <br />VALUE OF PROPOSED PROJECT <br />NOTE: Pursuant t4 It' 6 -1,1- 13.1 -5: i (tl) {a) the MANUFACTURING <br />E ul MENT <br />R gt D EQUIPMENT Loc►sT ❑1ST IT EQUIPMENT <br />EQUIPMENT <br />COST of the proreity is confidential. COST ASSESSED <br />VALUE <br />COST AMSSED G4ST ASSESS@ COST ASSESSED <br />VALUE - - iLUE <br />.dunentvalues <br />Filed <br />in C-I k S Office <br />Plus estimated values. of proposed project _ <br />- <br />1,200,000 <br />360,000 <br />El <br />- --- <br />- <br />- <br />Less values of any property being replaced <br />I <br />-- -- <br />-_ <br />Net 6slimated values upon completion of project <br />_ <br />SECTION 5 WASTE CONVERTED AND . <br />-. . BY <br />Estimated solid waste converted (pounds) <br />Estimated hazardous wa <br />a cnnv�F-10" t 'V _ - _ <br />Omerbenents: - <br />- — - - — - CITY CLERK, SC?1JT1H PFJD, IM <br />SECTION a TAXPAYER CERTIFICATION <br />1 hereby ce�lfy that the rtlpmaniatlans In this statement are true: <br />SfgnatureoFauthorized repriesersietive <br />Dales! ned monNf, -da ear <br />� � )-year <br />k <br />— - <br />printed name of atilhorlted representaAye _ <br />Tile `• - <br />Page t of 2 <br />