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STATEMENT OF BENEFITS <br />FORM SB -1 I PP <br />PERSONAL PROPPERTY RTY <br />Stale Form 51764 (112 / 12 -11) <br />Prescribed by the Department of Local Government Finance PRIVACY NOTICE <br />The cost and any specific individual's <br />=ofis confidential: the <br />balance of the filing is tc record <br />er IC 6d.1- 12.III i jc) and d <br />INSTRUCTIONS. ) <br />t, This statement Must be submitted to the body designating the Economic Revitalizafon'Ares prior to the public hearing if the designating body requires <br />infounation from tha applicant in making its decision about whethertc 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 /or research and development equipment. and/orlogistical distribution <br />equipment and/or, information techno logy equipment for which the person wishes to claim a deduction. Pr %cts "planned or committed to after July 1. 1967. <br />and areas designated after July 1, 1967, require a STATEMENT OF BENEFITS. (IC 6.1.1 -121) <br />2. Approval of the designating body (City Council, Town Board, County Council, etc.) must be obtained priorto installation of the new manufacturing equipment <br />and/or research and development equipment and /orlogistical 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 cedifled deduction schedule with the person's personal properly return on a cert/fied 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 fled between March 1 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 hilly functional, unless a filing <br />extension has been obtained. A person who obtains a filing extension must Ale the form between March 1 and the extended due date of that year <br />4. Property 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 1C 6- 1.1- 12.1- 4.5(d) and (a) 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 />Name of taxpayer <br />Federal Mogul Powertrain, LLC <br />Address of taxpayer (numberand street city slate, and ZIP codal <br />3605 W. Cleveland Rd., South Bend, IN 46628 <br />i <br />Name of contact person Telephone number <br />William Maki, Plant Controller <br />(574)271 -5910 <br />Name of designating body Resokn:on number is <br />City of South Bend Common Council <br />Location or property County OLGF taxing district number <br />3605 W. Cleveland Rd., South Bend, IN 46628 SL Jose h 71008 - German Twp. <br />Description of manufacturing equipment and /or research and development equipment ESTIMATED <br />and /or logistical distribution equipment and /or information technology equipment. <br />(use additional sheets if necessary) START DATE COMPLETION DATE <br />1) Manufacturing Equipment- Chrysler GMET4 Line Manufacturing Equipment March, 2016 August, 2017 <br />2) Manufacturing Equipment - General Motors Uplift Line R & D Equipment 1 <br />I <br />Logist Dist Equipment <br />3) Manufacturing Equipment - GM Duramax Assembly Machine <br />iT Equipment <br />Current number Salaries Number retained Salaries Number additional Salaries <br />544 36,485,146 544 36,485,146 0 0 <br />MANUFACTURING LOGIST DIST <br />NOTE: Pursuant to IC 6 -1.1- 12.1 -5.1 (d) (2) the EQUIPMENT R 8 D EQUIPMENT EQUIPMENT IT EQUIPMENT <br />COST of the property is confidential. COST ASSESSED COST ASWSSED COST ASSESS VALUE <br />ES COST ASSESSED <br />VALUE i <br />Current Values 117,828,028 31,925,970 <br />Plus estimated values of proposed project 11,315,200 3,394,560 <br />Less values orany property being replaced o o <br />Net estimated values upon completion of project 129,943,726 35,320,430 I <br />111111111441011114 . Estimated solid waste converted (pounds) WA <br />lP ) Estimated hazardous waste convert (poun )NIA <br />Other Matti: <br />In adS1ton i�o 544 high paying manufacturing jobs being retained by these projects from this new business, If rded t the Fjil r� fad, <br />continual investment by Federal -Mogul in its South Bend facility insures it will remain competitive not only nag naly, b more 1 �y►�p i <br />Internationally, and thus ensures its long -term viability to remain a reliable, high - paying employer in the St. Jo ph Co the C' of South Be d. <br />SECTION • r <br />I Weby certify that the representations in thW statement are true. r �� <br />i(gnalure of authoriz p esentative 'Rile Date signed (month, day, year) <br />Plant Controller j <br />March 14, 2016 , <br />Wt li Maki, CPA, Plant Controller ` <br />Page 1 of 2 <br />