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t ""TE APPLICATION FOR DEDUCTION FROM AS <br />'~ ~ - ~' OF STRUCTURES IN ECONOMIC REVITALI <br />~\ " State Form 18379 (R10 110-08) <br />µ.~ i <br />~'~ --~~'' Prescribed by the Department of Local Government Finance <br />ie s <br />r pP <br />/~ ! ~' <br />L-i1ATION <br />.AS (E~A~`~~~ <br />1\~G 3 <br />u,~~, liter <br />f 20_ PAY 20_ <br />(\ FORM 322 / RE I <br />INSTRUCTIONS: ~ c <br />1. This form is to be filed in person or by mail with the Auditor of the county in whi the p opert~.isrjo6atecl before May 10 of the year in which addition to <br />assessed valuation (or new assessment) is made, or not later than thirty (30) day after mailQigliafe of notice of assessment (Form 11) if such notice is <br />not given before April 10 of that year (IC 6-1.1-12.1-5). <br />2. Copy of Form 11 must be attached. <br />3. A property owner may not receive this deduction for the same property or improvements for which a deduction is obtained under either IC 6-1.1-12-18, <br />IC 6-1.1-12-22 orlC 6-1.1-12-28.5 (lC 6-1.1-12.1-6). <br />4. A copy of the statement of benefits (Form SB-1 /Real Property) must be attached to this application. <br />5. The compliance with statement of benefits (Form CF-1 /Real Property) must be filed with this application and the designating body (IC 6-1.1-12.1-5.1). <br />6. A copy of the resolution must be attached to this application. <br />7. Please see IC 6-1.1-12.1 for further instructions. <br />8. Taxpayer completes Sections t, II and III below. <br />9. If property located in an economic revitalization area is also located in an allocation area as defined in IC 36-7-14-39 or /C 36-7-15.1-26, an application <br />for the property tax deduction may not be approved unless the Commission that designated the allocation area adopts a resolution approving the <br />application (IC 6-1.1-12.1-2(k)). <br />10. Except for ERA's designated before December 31, 1987, a deduction for redevelopment or rehabilitation is not authorized for the following facilities <br />(IC 6-1.1-12.1-3). <br />a. Private or commercial golf course j. Any facility, the primary purpose of which is (a) Retail food and <br />b. Country club beverage service; (b) Automobile sales or service; or (c) other <br />c. Massage parlor target areaeestatblishedlunder IC 6 d 1 12 ie) nomic development- <br />d. Tennis court k. Residential, unless the facility is amulti-family facility that <br />e. Skating facility, including roller skating, skateboarding or ice skating contains at least 20% of the units avarlable for use by low and moderate <br />f. Racquet sport facility (including handball or racquet ball court) income individuals or unless the facility is located in an <br />g. Hot tub facility economic development target area established under IC 6-1.1-12. f-7, or <br />h. Suntan facilit the area is designated as a residentially distressed area which <br />Y is required to meet conditions as cited in IC 6-1.1-12.1-2 (c) (1 & 2). <br />i. Racetrack <br />1. Package liquor store jsee IC 6-1.1-12.1 - 3(e)(12)] <br />SECTION I -DESCRIPTION OF PROPERTY <br />The owner hereby applies to the County Auditor for a deduction pursuant to IC 6-1.1-12.1-5 beginning with the assessment date March 1, 20 11 <br />County <br />St. Joseph Township <br />Portage DLGF taxing district number Key number <br />018-5107-3766 <br />Name of owner <br />Snyder Custom Builders, Inc. <br />Property address (number and street, city, state, and ZIP code) <br />727 East Corby Street, South Bend, IN 46617 <br />Legal description from Form 11 <br />Lot 135 & part of Lot 136, Sorin's 2nd Addition Date of Form 11 (month, day, year) <br />Type of structure <br />Single family residence Use of structure <br />Single Family Residential <br />Governing body that approved ERA designation <br />South Bend Common Council Resolution number <br />Date ERA designation approved (must be before March 1) <br />SECTION II -VERIFICATION OF OWNER OR REPRESENTATNE <br />Signat of owner or representativ (1 hereby c ify that the representations on this application are true) Date ~gned (m nth, day, year) <br />~~ LD <br />Address (number nd sfr t, Crty, slat nd ZIP code) <br />P.O. Box 6035, South Ben , IN 46660 <br />SECTION III -STRUCTURES ~ • ' <br />A. Rehabilitation structure 1. Assessed valuation AFTER rehabilitation $ <br />2. Assessed valuation at 100% of TTV BEFORE rehabilitation $ <br />3. INCREASE in assessed valuation $ <br />4. Assessed valuation eligible for deduction $ <br />B. New structure 1. Assessed valuation $ <br />2. Assessed valuation eligible for deduction $ <br />SECTION IV -VERIFICATION OF ASSESSING OFFICIAL <br />I verify that the above described structure was assessed and the owner was notified on with the <br />effective date of the assessment being March 1, 20 and that the assessed valuations in Section III are correct. <br />Signature of Assessing Official Township Date (month, day, year) <br />CONTINUED ON THE REVERSE SIDE <br />