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. . STATEMENT OF BENEFITS FORM SB•1/PP PERSONAL PROPERTY �` f State Form 51764(R3/12-13) Prescribed by the Department of Local Government Finance PRIVACY NOTICE Any Information concerning the cost t of the property and specific salaries paid to individual employees by the property • owner Is confidential per IC 6.1.1.12.1-5.1. INSTRUCTIONS 7. This statement must be submitted to the body designating the Economic Revitalization Area prior to the public hewing if the designating body requires -. information from the applicant in making Its decision about whether to designate an Economic Revitalization Area. Otherwise this statement must be submitted to the designating body BEFORE a person Installs the new manufacturing equipment and/or research and development equipment,and/or logistical distribution equipment and/or Information technology equipment for which the person wishes to claim a deduction. 2. The statement of benefits form must be submitted to the designating body and the area designated an economic revitalization area before the installation of qualifying abatable equipment for which the person desires to claim a deduction. • 3. To obtain a deduction, a person must fife a certified deduction schedule with the person's personal property return on a certified deduction schedule (Form 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 township. The 103-ERA must be filed between March 1 and May 15 of the assessment year in which new manufacturing equipment and/or research and development equipment and/or logistical distribution equipment and/or information technology equipment is installed and fully functional,unless a tiling 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. 4. Property owners whose Statement of Benefits was approved,must submit Form CF-1/PP annually to show compliance with the Statement of Benefits. .• (IC 6-1.1.12.1.56) 5. Fora Form 5B-1/PPthat is approved after June 30,2013,the designating body is required to establish an abatement schedule for each deduction allowed. Fora Form SB-1/PP that is approved prior to July 1,2013,the abatement schedule approved by the designating body remains/n effect. (IC 64.1-12.1-17) • • SECTION 1 TAXPAYER INFORMATION Name of taxpayer Name of contact person TOA USA LLC DON STOCK Address of taxpayer(number and street,d4 state,and ZIP cafe) Ibiephone number 2000 Pleiades Drive,Mooresville,IN 46158 ' ( 317 ) 834-8721 t SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT Name of designating body Resolution number(s) Mooresville Town Council,Town of Mooresville • Location of property County DLGF taxing district number . PT LOT 1 RAWLINGS MINOR PLAT;69.36 ACRES ' Morgan 55005 Description of manufacturing equipment and/or research and development equipment ESTIMATED and/or logistical distribution equipment and/or Information technology equipment. START DATE COMPLETION DATE (Use additional sheets If necessary.) See Attachment. Manufacturing Equipment 10/01/2014 11/01/2014 R&D Equipment Logist Dist Equipment • IT Equipment SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT Current number Salaries Number retained Salaries Number additional Setarles 466 $15,225,805.40 466 $15,225,805.40 20 $605,397.36 . SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT • NOTE:Pursuant to IC 6.1.1-12.1-5.1(d)(2)the MANUFACTURING R&O EQUIPMENT LOGIST DIST IT EQUIPMENT _ EQUIPMENT EQUI_PMENT _ COST of the property Is confidential. COST A VALUE COST A VALUEDCOST ALOE O COST ASSESSED values .. Plus estimated values of proposed project 400,000 _ Less values of any property being replaced 0 Net estimated values upon completion of project 400,000 SECTION 5 WASTE CONVERTED AND OTHER B REFITS PROMISED BY THE TAXPAYER . Estimated solid waste converted(pounds) 0 Estimated hazardous waste convened(pounds) 0 Other benefits: SECTION 6 TAXPAYER CERTIFICATION I hereby certify th, • represent to in this statement are true. . , Signature of authorize. epresen Date signed(month,day,year) April 2,2014 Printed name of authori representative Title Don Stock I Executive Director Manufacturing Page 1 of 2