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<br />'Jp4;"' <br />"~f ~'~TF°-i <br />~~~ STATEMENT OF BENEFITS <br />„: <br />y _! PERSONAL PROPERTY <br />•'• ~ Stale Form 51764 (6-041 <br />°-'-.:-~' Prescribed by the Department of Local Government Finance <br />FORM <br />SB -1 l PP - <br />INSTRUCTIONS: <br />1. This statement must be submitted to the body designating the economic revitalization area prior to the public hearing if the designating body requires <br />information from fhe applicant in making its decision about whether to designate an Economic Revitalization Area. Otherwise this statement moist be submitted <br />td the designating body BEFORE a person installs tfie new manufacturing equipment and/or research 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 o/ the designating body (City Council, Town Board. Cocinty 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, Form 322 ERA/PPME and/or Form 322 ERA/PP Other, must be filed with the county auditor. Form 322 ERA/PPME and/or Form 322 <br />ERA/PP Other must be filed between March 1 ancJ May 15 of fhe assessment year in which new manufacturing equipment and/or research and development <br />egeiipmerit and/or logistical distribution equipment and/or information technology equipment becomes assessable, unless a filing extension has been <br />obtained. A person who obtains a filing extensfon must (ile 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 annually to show compliance with fhe Statement <br />of benefits. (IC 6-1. i-12.1-5.6) <br />5. The schedules established under IC 6-i.7-72. i-4(d) and IC 5-1.1-12.1-4.5(e) effective July 1, 2000 apply to any statement of benefits filed on or after <br />Jtrly 1, .2000. The schedules effective prior to July 1, 2000 shali.contincie td apply to those statement of benefits filed before July 1: 2000. <br />Name of taxpayer <br />Address of taxpayer (street anU number city, state and ZIP code) <br />Name of contact person <br />number <br />Name of designating body ~Resolulion number <br />n.. .r.-u nn. ~ rr <br />~`~ v Count <br />y Taxing distract <br />Location of property <br />CI kW ~ `- q ^ Si <br />t andlor rose rch and development equipment <br />i ,JO i 7 r <br />ESTIMATED <br />pmen <br />Description of manufacturing qu t D <br />andlor logistical distribution egwpment andlor information technology equipmen Start Uate ate <br />Completion <br />(use additional sheets if necessary) <br />~rtdy~ING MAc-f+rwE~, <br />cA/L G <br />i Manufacturing Equipment ~~ <br />, <br />~ <br />C c A R He [/-',~tNG NgGr~tJd t ~f~ R& D Equipment <br />CWG C.ATNE S ~3~ Logist Dist Equipment' <br />G1~tG MAoH1N1UG c.Ertr~R ~I~ <br />pFt3wRRtN U rvtA~l-rt-+E ~ IT Equipment' <br />intr .AL Gc'JtR GRINDING TI f <br />Current number Salaries Number retained Salaries Number additional Salaries O <br />~c a 6 <br />a.8s / 0° G .2ssa.~fi'/_ 00 <br /> -.•. ~ •-. <br /> <br />NOTE: Pursuant to IC 6-1.1-12.1-5.1 (d) (2) the Manufacturing <br />Equipment R g D Equipment Logist Dist Equipment' IT Equipment' <br />COST of the property is confidential. Assessed <br />Cost Assessed Assessed <br />Cost <br />Cost Value Cost Assessed <br />Value <br /> Value Value <br />Current values c^0 <br />Plus estimated values of proposed project o ppq <br /> <br />Less values of any property being replaced . r <br />~ <br />t <br />Net estimated values upon completion of project ~- •r ~ ~ :~ ~r ~ <br />+~ . ~ r • <br />Estimated solid waste converted (pounds) <br />Other benefits: <br />Estimated~azardaus waste con'er~d jp, gt(~ds) <br />``11 AUG LUU <br />JQ~°u v`6 N7 <br />Signature of authorized representative <br />I hereby certify that the representations in this statement are true. <br />Title Dafe signed (month, day, year) <br />* See IC fi-1.1-12. <br />