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STATEMENT OF BENEFITS
<br />PERSONAL PROPERTY
<br />S Slate Form 51764 (R2 / 12 -11)
<br />r' Prescribed by the Department of Local Government Finance
<br />FORM SBA / PP
<br />PRIVACY NOTICE
<br />The cost and any speciFiic individual's
<br />salary information is confidential; the
<br />balance of the filing is public record
<br />per IC 6- 1.1-12.1 -5.1 (c) and td1 .
<br />INS FRUCTIONS;
<br />1, This statement must be submitted to the body designating the Economic Revilalization'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 submitted
<br />to the designating body BEFORE a person installs the new manufacturing equipment and /orresearch and development equipment. and /or logistical distribution
<br />equipment and /or information technology equipment for which the person wishes to claim a deduction. `'Projects" planned or committed to after July 1. 1987,
<br />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 installation of the new manufacturing equipment
<br />and /or research and development equipment and /or logistical distribution equipment and /or information technology equipment, BEFORE a deduction may
<br />be approved
<br />3. To obtain a deduction, a person must file a certified deduction schedule with the person's personal property return on a certified deduction schedule (Form
<br />103 -ERA) with the township assessor of the township where the property is situated or with the county assessor if there is no township assessor for the
<br />township. The 103 -ERA must be filed between March f and May 15 of the assessment year in which new manufacturing equipment and /or research and
<br />development equipment and /or logistical distribution equipment and /or Information technology equipment is installed and fully functional, unless a filing
<br />extension has been obtained, A person who obtains a filing extension must file the form between March 1 and the extended due date of that year,
<br />4. Properly owners whose Statement of Benefits was approved after June 30, 1991, must submit Form CF -1 / PP annually to show compliance with the
<br />Statement of Benefits- (IC 6 -1,1- 12.1 -5.6)
<br />5. The schedules established under IC 6- 1.1- 12.1- 4.5(d) and (e) apply to equipment installed after March 1, 2001, unless an alternative deduction schedule is
<br />adopted by the designating body (IC 6 -1.1- 12.1 -17).
<br />current number aaianes m,moer manee
<br />544 36,485,146 544
<br />NOTE: Pursuant to IC 6 -1.1- 12.1 -5.1 (d) (2) the
<br />COST of the property is confidential,
<br />MANUFACTURING
<br />EQUIPMENT
<br />COST ASSESSE
<br />VALUE
<br />Name, nftaxpayer
<br />117,628,028
<br />31,925,870
<br />Federal Mogul Powertrain, LLC
<br />11,315,200
<br />3,394,560
<br />Address of taxpayer (bumberand slreel. city, state, and ZIP code)
<br />e
<br />0
<br />3605 W, Cleveland Rd., South Bend, IN 46628
<br />128,943,228
<br />35,320,430
<br />Name of contact person
<br />.
<br />Telephone number
<br />William Maki, Plant Controller
<br />1(574) 271 -5910
<br />o
<br />`
<br />Name of designalhig body
<br />Resolution number ts;
<br />Citv of South Bend Common Council
<br />Location of property
<br />County
<br />DLGF taxing district number
<br />3605 W. Cleveland Rd., South Bend, IN 46628
<br />St. Joseph
<br />71008 - German Twp.
<br />Description of manufacturing equipment and /or research and development equipment
<br />ESTIMATED
<br />and /or logistical distribution equipment and /or information technology equipment.
<br />I COMPLETION DATE
<br />(use additional sheets ff necessary)
<br />START DATE
<br />Manufacturing Equipment March, 2016
<br />1) Manufacturing Equipment- Chrysler GMET4 Line
<br />R & D Equipment
<br />2) Manufacturing Equipment - General Motors Uplift Line
<br />Logisl Dist Equipment
<br />LAugust2017
<br />3) Manufacturing Equipment - GM Duramax Assembly Machine
<br />IT Equipment
<br />current number aaianes m,moer manee
<br />544 36,485,146 544
<br />NOTE: Pursuant to IC 6 -1.1- 12.1 -5.1 (d) (2) the
<br />COST of the property is confidential,
<br />MANUFACTURING
<br />EQUIPMENT
<br />COST ASSESSE
<br />VALUE
<br />Current values
<br />117,628,028
<br />31,925,870
<br />Plus estimated values of proposed project
<br />11,315,200
<br />3,394,560
<br />Less values of any property being replaced
<br />e
<br />0
<br />Net estimated values upon completion of project
<br />128,943,228
<br />35,320,430
<br />.
<br />° •
<br />Estimated solid waste converted (pounds) NIA
<br />Salaries Number additional
<br />36,485,146 0
<br />R & D EQUIPMENT LOGIST DIST IT EQUIPMENT
<br />EQUIPMENT 1
<br />COST I ASS\IAESSED COST I ASSESSED I COST I ASSES;
<br />1 1 IG
<br />Estimated hazardous waste
<br />Oher en" high paying 9 y p
<br />n t adc�l'o 0 544 hl h a n manufacturing Jobs being retained b these projects from this new business, if
<br />continual investment by Federal -Mogul in Its South Bend facility Insures It will remain competitive not only na
<br />internationally, and thus ensures its long -term viability to remain a reliable, high - paying employer in the St. J(
<br />, oyt more
<br />of South
<br />I Keby certify that the representations in this statement are true, I- "0 ` _ J
<br />Signature of authorix p esentatiVe Title Dale slgned (month, day, year)
<br />Plant Controller March 14, 2016
<br />Wirldn Maki, CPA, Plant Controller Page 1 of 2
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