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14) . STATEMENT OF BENEFITS 20 PAY 20 FORM SB-1 I Real Property "'" REAL ESTATE IMPROVEMENTS `-Jj!+gl Slate Form 51787(R5f 12-13) Prescribed by the Department of Local Government Finance PRIVACY NOTICE_ This statement Is being completed for real properly that qualifies under the following Indiana Code(check one box): Any Information eoncamin's the cost ©Redevelopment or rehabilitation of real estate Improvements(IC 8-1.1.12.1-4 of id t properly and specificsalariesthe P P ) paid properly al d sployaos by the 0 Residentially distressed area(IC 6-1.1-12.1.4.1) rerocietz.M.confidentleil per INSTRUCTIONS: 1. This statement must be submitted to the body designating the Economic RevitahYalfon Area prior to the public hearing Y 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 designatioQ body BEFORE the redevelopment or rehabilitation of real properly 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 revile/dation area before the initiation of the redevelopment or rehabilitation for which the person desires to claim a deduction. 3. To obtain a deduction,a Form 322/RE must be bled with the County Auditor before May 10 in the year in which the addition to assessed valuation is made or not later than thirty(30)days after the assessment notice is mailed to the property owner if/t was malted ager April 10. A propedyownerwho failed fo file a deduction application within the prescribed deadline may Ale an application between March 1 and May 10 of a subsequent year. 4 A property owner who files for the deduction must provide the County Auditor and designating body with a Form CF-1/Real Property. The Form CF-1/Reat Property should be attached to the Form 322/RE when the deduction Is first claimed and then updated annually foreach year the deduction Is applicable. IC 6.1.1.12.1-5.1(b) 5. For a Form 58-1/Real Property that is approved after June 30, 2013, the designating body Is required to establish an abatement schedule for each deduction allowed. For a Form 88-1/Reat Property(hat is approved prior to July 1,2013, the abatement schedule approved by the designating body remains In effect. IC 6-1.1.12.1-17 SECTION 1 TAXPAYER INFORMATION Name of taxpayer TOA USA LLC Address of taxpayer(number and sheet ply stele,end ZIP code) .... 2000 Pleiades Drive, Mooresville, IN 46158 Name of contact person Telephone number E-mail address Don Stock ( 317 1834-8721 dstock@TOA-USA.com SECTION 2 LOCATION AND DESCRIPTION OF PROPOSED PROJECT Name of des gosling body Resolution number Mooresville Town Council,Town of Mooresville c! _ Location of property — County DLOF taxing district number ^ LOT 2 RAVVLINS MINOR PLAT; 10.064 ACRES _ I Morgan 55005 Deecrlptlon or real property improvements,redevelopment,or rehabilitation(use additional sheets if necessary) Estimated start date(month,day,year) Add additional production building on the property. See Exhibit A. 06(01/2014 Estimated compleson date(month,day,year) 10/01/2015 SECTION 3 ESTIMATE OF EMPLOYEES AND SALARIES AS RESULT OF PROPOSED PROJECT Current number Salaries Number retained Salaries Number additional Salaries 468.00 $15,225,805.40 466.00 $15,225,805.40 200.00 $4,911,150.40 SECTION 4 ESTIMATED TOTAL COST AND VALUE OF PROPOSED PROJECT REAL ESTATE IMPROVEMENTS _ COST ASSESSED VALUE Currant values _Plus estimated values of proposed project 21,090,000.00 Less values of any properly being replaced 773,100.00 Net estimated values u.on com.lellon of.ro'ect 20 ,316,900.00 SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER Estimated solid waste converted(pounds) 0.00 Estimated hazardous waste converted(pounds) 0.00 Other benefits SECTION S TAXPAYER CERTIFICATION I hereby certify that- e repres-illationsin this statement are true. Signature of authorised -•rasen:'. • Dale signed(month,day,year) �,.� '- 104/02/2014 Printed no-TT-authorized representative Toe Don Stock Executive Director Manufacturing ~ H- Page 1 of 2