HomeMy Public PortalAbout07 - 2022-7 - PREMIUM BRANDS SERVICES, LLC COMPLIANCE WITH STATEMENT OF BENEFITS RESOLUTION NO. 2022 - 7
COMMON COUNCIL OF THE CITY OF GREENCASTLE, INDIANA
A RESOLUTION AFFIRMING
PREMIUM BRANDS SERVICES, LLC
formerly known as ASCENA RETAIL GROUP, INC.
OF COMPLIANCE WITH STATEMENTS OF BENEFITS
WHEREAS, Ascena Retail Group (now known as Premium Brands) has heretofore been
granted certain tax abatements in consideration of certain benefits for the City of Greencastle;and,
WHEREAS, said company has submitted the following forms as of May 16,2022:
CF-1/RE for tax abatement on a facility renovation granted in 2012,
CF-1/RE for tax abatement on a facility expansion granted in 2015,
CF-1/PP for tax abatement granted on equipment in 2012 and amended in 2014, &
CF-1/PP for tax abatement granted on equipment granted in 2015.
WHEREAS, the Common Council has reviewed the CF-1 forms, copies of which are
attached hereto, and has found compliance with the previously approved Statements of Benefits.
NOW THEREFORE BE IT RESOLVED that the Common Council of the City of
Greencastle, Putnam County, Indiana, approves the CF-1 forms as submitted as being in
compliance with the Statements of Benefits previously filed by Ascena Retail Group, Inc.
BE IT FURTHER RESOLVED that this Resolution be made a record and filed along with
the CF-1 forms with the Putnam County Auditor.
PASSED by the Common Council of the City of Greencastle at its regular meeting this 7th
day of July 2022.
COMMON COUNCIL OF THE CITY OF GREENCASTLE, INDIANA
.Afr AKA'
Adam C hen ody ert
P__—
ammer Stacie L Id. I
v' „nay Veronica Pejril
',
Darrel Thomas
Approved and signed by me this 7th day of July 2022 at "1%31 p.m. o'clock.
ATTE T: William A. Dory, Jr., Mayor
L da R. Dunbar, Clerk-Treasue-
•
COMPLIANCE WITH STATEMENT OF BENEFITS I PRIVACY NOTICE FORM CF-1 /PP
PERSONAL PROPERTY This form contains confidential
State Form 51765(RS!12-21) information pursuant to January 6-1.1-35-9 and IC 6-1.1-12,1-5.6. 1,2022
„ d Prescribed by the Department of Local Government Finance
INSTRUCTIONS: 1. Property owners whose Statement of Benefits was approved must file this form with the local Designating Body to show the extent
to which there has been compliance with the Statement of Benefits. (IC 6-1.1-12.1-5.8)
2. This form must be filed with the Form 103-ERA Schedule of Deduction from Assessed Value between January 1 and May 16,2022,
unless a filing extension under lC 6-1.1-3.7 has been granted. A person who obtains a fling erdenslon must file between
January 1 and the extended due date of each year.
3. With the approval of the designating body,compliance information for multiple projects may be consolidated on one(1)compliance(CF-1).
.ECTION 1 TAXPAYER INFORMATION
Name of taxpayer County
Premium Brands Services, LLC Putnam
Address of taxpayer(number and street,city,state,and ZIP code) DLGF taxing district number
8323 Walton Pkwy, New Albany,OH 43054 67008
Name of contact person Telephone number
Monica Kilgren (614 775-3280
.ECTION 2 LOCATION AND DESCRIPTION OF PROPERTY
Name of designating body Resolution number Estimated start date(month,day,year)
Greencastle Common Castle 2012-4&2012-27 1/1/2013
Location of property Actual start date(month,day,year)
1901 State Highway 240,Greencastle, IN 46135 1/1/2013
Deswalption of new manufacturing equipment,or new research and development equipment,or new information technology Estimated completion date(month,day,year)
equipment,or new logistical distribution equipment to be acquired.
12/31/2015
New state-of-the-art distribution equipment and IT for the proposed e-commerce distribution Actual completion date(month,day,year)
operation in Greencastle, IN. 12/31/2015
-ECTION 3 EMPLOYEES AND SALARIES
EMPLOYEES AND SALARIES AS ESTIMATED ON SB-1 ACTUAL
Current number of employees 181 679
Salaries $5,297,074 $25,449,548.80
Number of employees retained 181 181
Salaries $5,297,074 $8,323,038.80
Number of additional employees 242 498
Salaries $8,114,163 517,128,512.00
-ECTION 4 COST AND VALUES
MA
NUFACTURING? R D EQUIPMENTE R EQUPMBJT
COST ASSESSED COST COST ASSESSED ASSFSSED ASSESSED
AS ESTIMATED ON SBA COSTVALUE VALUE COST VALUE
Values before project
Plus: Values of proposed project 550,000,000 $20,000,000 $12,000,000 $4,800,000
Less: Values of any property being replaced
Net values upon completion of project
ACTUAL ASSESSED ASSESSED ASSESSED ASSESSED
COST VALUE COST VALUE COST VALUE COST VALUE •
Values before project
Plus: Values of proposed project $7,086,324 $1,062,949 S71,872 $10,781
Less: Values of any property being replaced
Net values upon completion of project $7,088,324 $1,062,949 $71,872 $10,781
NOTE:The COST of the property is confidential pursuant to IC 6-1.1-12.1-5.6(c).
ECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER
WASTE CONVERTED AND OTHER BENEFITS AS ESTIMATED ON SB-1 ACTUAL
Amount of solid waste converted
Amount of hazardous waste converted
Other benefits:
•ECTION 6 TAXPAYER CERTIFICATION
I hereby certify that the representations in this statement are true.
Signature of authorized representative 1 Title Date signed(month,day,year)
VP Corp Tax S (3 r Z0 2-2—
Page 1 of 2
OPTIONAL: FOR USE BY A DESIGNATING BODY WHO ELECTS TO REVIEW THE COMPLIANCE WITH STATEMENT OF BENEFITS(FORM CF-1)
INSTRUCTIONS: (IC 6-1.1-12.1-5.9)
1. Within forty-five(45)days after receipt of this form,the designating body may determine whether or not the property owner has substantially complied with
the Statement of Benefits.
2. If the property owner is found NOT to be in substantial compliance,the designating body shall send the property owner written notice. The notice must
include the reasons for the determination,including the date,time and place of a hearing to be conducted by the designating body. If a notice is mailed to
a property owner,a copy of the written notice will be sent to the county assessor and the county auditor.
3. Based on the information presented at the hearing,the designating body shall determine whether or not the property owner has made reasonable effort to
substantially comply with the Statement of Benefits and whether any failure to substantially comply was caused by factors beyond the control of the
property owner.
4. If the designating body determines that the property owner has NOT made reasonable effort to comply,the designating body shall adopt a resolution
terminating the deduction. The designating body shall immediately mail a certified copy of the resolution to:(1)the property owner, (2)the county auditor,
and(3)the county assessor.
We have reviewed the CF-1 and find that:
lig the property owner IS in substantial compliance
❑ the property owner IS NOT in substantial compliance
❑ other(specify)
Reasons for the determination(attach additional sheets if necessary)
Signature of auth a member Date signed(month,day,year)
Attested by: `J(///` — 33L4 �* 2.OZZ
Designating body
Cv2£. cvt5Jc Cowl/140 tiJ Cov�ic IL
If he property owner is found not to be in substantial compliance,the property owner shall receive the opportunity for a hearing.The following date and
time has been set aside for the purpose of considering compliance.
Time of hearing 0 AM Date of hearing(month,day,year) Location of hearing —�
❑ PM
HEARING RESULTS(to be completed after the hearing)
❑ Approved ❑ Denied(see instruction 5 above)
Reasons for the determination(attach additional sheets if necessary)
w
Signature of authorized member Date signed(month,day,year)
Attested by: Designating body
{ APPEAL RIGHTS[IC 6-1.1-12.1-5.9(e)j �.
A property owner whose deduction is denied by the designating body may appeal the designating body's decision by filing a complaint in the office of the
clerk of Circuit or Superior Court together with a bond conditioned to pay the costs of the appeal if the appeal is determined against the property owner.
Page 2 of 2
5.�� COMPLIANCE WITH STATEMENT OF BENEFITS PRIVACY NOTICE FORM CF-1 /PP
/4 This form contains confidential
i_.,,e PERSONAL PROPERTY
ai. . I . information pursuant to January 1 2022
State Form 51765(R6/12-21) IC 6-1.1-35-9 and IC 6-1.1-12.1-5.6. ry
's\„ Prescribed by the Department of Local Government Finance
INSTRUCTIONS: 1. Property owners whose Statement of Benefits was approved must file this form with the local Designating Body to show the extent
to which there has been compliance with the Statement of Benefits. (IC 6-1.1-12.1-5.6)
2. This form must be filed with the Form 103-ERA Schedule of Deduction from Assessed Value between January 1 and May 16,2022,
unless a filing extension under IC 6-1.1-3.7 has been granted. A person who obtains a filing extension must fle between
January 1 and the extended due date of each year.
3. With the approval of the designating body,compliance information for multiple projects may be consolidated on one(1)compliance(CF-1).
SECTION 1 TAXPAYER INFORMATION
Name of taxpayer County
Premium Brands Services,LLC Putnam
Address of taxpayer(number and street,city,state,and ZIP code) DLGF taxing district number
8323 Walton Pkwy,New Albany,OH 43054 67008
Name of contact person Telephone number
Monica Kilgren 614 j 775-3280
SECTION 2 LOCATION AND DESCRIPTION OF PROPERTY
Name of designating body Resolution number Estimated start date(month,dey,year)
Greencastle Common Castle 2015-19 7/1/2016
Location of property Actual start date(month,day,year)
1901 State Highway 240, Greencastle, IN 46135 2/1/2016
Descnption of new manufacturing equipment,or new research and development equipment,or new information technology Estimated completion date(month,day,year)
equipment,or new logistical distribution equipment to be acquired 6/30/2019
New state-of-the-art MHE and IT equipment to increase e-commerce fulfillment capacity. Actual completion date(month,day,year)
12/3112019
SECTION 3 EMPLOYEES AND SALARIES
EMPLOYEES AND SALARIES AS ESTIMATED ON SB-1 ACTUAL
_ Current number of employees 308
879
Salaries $11,800,000 $25,449,548.80
Number of employees retained _ _ 30e _ 30e
Salaries Si 1,800,000 $13,099,881.60
Number of additional employees 30 371
Salaries $998.400 $12,349,867.20
SECTION 4 COST AND VALUES
MANUFACTURING R&D EQUIPMENT LOGIST DIST IT EQUIPMENT
EQUIPMENT EQUIPMENT
AS ESTIMATED ON SB-1 COST ASSESSED COST COST ASSESSED ASSESSED
COST ASSESSED
VALUE VALUE VALUE
Values before project
Plus: Values of proposed project $35,000,000 $14,000,000 $4,500,000 $1,800,000
Less: Values of any property being replaced
Net values upon completion of project
ASSESSED COST ASSESSED COST ASSESSED cost
COST
ASSESSED
ACTUAL VALUE VALUE VALUE VALUE
Values before project •
Pius: Values of proposed project S7,354,061 S1,402,253 $194,736 Se6,603
Less: Values of any property being replaced
Net values upon completion of project 87,354,061 $1,402,253 $194,736 588,603
NOTE:The COST of the property is confidential pursuant to IC 6-1.1-12.1-5.6(c).
SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER
WASTE CONVERTED AND OTHER BENEFITS AS ESTIMATED ON SB-1 ACTUAL
Amount of solid waste converted
Amount of hazardous waste converted
Other benefits:
SECTION 6 TAXPAYER CERTIFICATION
I hereby certify that the representations in this statement are true.
Signature of authorized representative �/ Title Date signed(month,day,year)
1(�6�1/'T�D *--1 A C/lair 1 VP of Tax Jr j 2-2,c� Page 1 of 2
OPTIONAL: FOR USE BY A DESIGNATING BODY WHO ELECTS TO REVIEW THE COMPLIANCE WITH STATEMENT OF BENEFITS(FORM CF-1)
INSTRUCTIONS: (IC6-1.1-12.1-5,9)
1. Within forty-five(45)days after receipt of this form,the designating body may determine whether or not the property owner has substantially complied with
the Statement of Benefits.
2. If the property owner is found NOT to be in substantial compliance, the designating body shall send the property owner written notice. The notice must
include the reasons for the determination,including the date,time and place of a hearing to be conducted by the designating body. If a notice is mailed to
a property owner,a copy of the written notice will be sent to the county assessor and the county auditor.
3. Based on the information presented at the hearing,the designating body shall determine whether or not the property owner has made reasonable effort to
substantially comply with the Statement of Benefits and whether any failure to substantially comply was caused by factors beyond the control of the
property owner.
4. if the designating body determines that the property owner has NOT made reasonable effort to comply,the designating body shall adopt a resolution
terminating the deduction. The designating body shall immediately mail a certified copy of the resolution to:(1)the property owner;(2)the county auditor,
and(3)the county assessor.
We have reviewed the CF-1 and find that:
lig the property owner IS in substantial compliance
❑ the property owner IS NOT in substantial compliance
❑ other(specify)
Reasons for the determination(attach additional sheets if necessary)
Signature of auth e member _ —Date signed(month,day year)
Attested by
Designating body /
G2“ C-61SC;IC— COtniMo.+J r✓oviAJC" IL
If he property owner is found not to be in substantial compliance,the property owner shall receive the opportunity for a hearing.The following date and
time has been set aside for the purpose of considering compliance.
Time of hearing ❑AM Date of hearing(month.day,year) Location of hearing -- _
— ❑PM I
HEARING RESULTS(to be cotnpleted after the hearing)
0 Approved 0 Denied(see instruction 5 above)
Reasons for the determination(attach additional sheets if necessary) ^'
I i
Signature of authorized member Date signed(month,day,year)
Attested by: Designating body _—
APPEAL RIGHTS[IC 6-1.1-12.1-5.9(e)]
A property owner whose deduction is denied by the designating body may appeal the designating body's decision by filing a complaint in the office of the
clerk of Circuit or Superior Court together with a bond conditioned to pay the costs of the appeal if the appeal is determined against the property owner.
Page 2 of 2
COMPLIANCE WITH STATEMENT OF BENEFITS RECEIVED 20 22 PAY 20 23
44 14.. - REAL ESTATE IMPROVEMENTS
� k FORM CF-1 I Real Pro State Form 51788(R5/12-21) I�AY 1 8 2022 arty
Prescribed by the Department of Local Government Finance
PRIVACY NOTICE
INSTRUCTIONS: P M COUNTY AUDITOR The cost and any specific individual's
1. This form does nottapply to property located in a residentially distressed area or any ilt,'ffor!lbr which the salary information is confidential;the
Statement of Bene s was approved before July 1, 1991. balance of the filing is public record
2. Property owners must file this form with the county auditor end the designating body for their review regarding per IC 6-1.1-12.1-5.3(k)and(I).
the compliance of the project with the Statement of Benefits (Form SB-1/Real Properly).
3. This form must accompany the initial deduction application(Form 322/RE)that is filed with the county auditor.
4. This form must also be updated each year in which the deduction is applicable. It is filed with the county auditor
and the designating body before May 16,2022,ar by the due date of the real property owner's personal property
return that is filed in the township where the property is located. (IC 6-1.1-12.1-5.3(j))
5. With the approval of the designating body,compliance information for multiple projects may be consolidated on
one(1)compliance form(Form CF-1/Real Property).
SECTION 1 TAXPAYER INFORMATION
Name of taxpayer County
Premium Brands Services, LLC and ANSA Propco Partnership LP Putnam
Address of taxpayer(number and street,city,state,and ZIP code) DLGF taxing district number
8323 Walton Pkwy, New Albany,OH 43054 67008
Name of contact person Telephone number
Monica Kilgren ( 614 ) 775-3280
-ECTION 2 LOCATION AND DESCRIPTION OF PROPERTY
Name of designating body Resolution number Estimated start date(month,day,year)
Greencastle Common Council 2012-4&2012-27 1/1/2012
Location of property Actual start date(month,day,year)
1901 State Highway 240, Greencastle, IN 46135 3/14/2012
Description of real property improvements Estimated completion date(month,day,year)
Renovation of existing facility for e-commerce 12/31/2014
Actual completion date(month,day,year)
12/31/2014
SECTION 3 EMPLOYEES AND SALARIES
EMPLOYEES AND SALARIES AS ESTIMATED ON SB-1 ACTUAL
Current number of employees 181 679
Salaries 35,297,074 $25,449,548.80
Number of employees retained 181 181
Salaries $5,297,074 $6,323,036.80
Number of additional employees 242 498
Salaries $8,114,163 $17,126,512.00
•ECTION 4 COST AND VALUES
COST AND VALUES REAL ESTATE IMPROVEMENTS
AS ESTIMATED ON SB-1 COST ASSESSED VALUE
Values before project
Plus: Values of proposed project $3,000,000
Less: Values of any property being replaced
Net values upon completion of project
ACTUAL COST ASSESSED VALUE
Values before project
Plus: Values of proposed project $3,410,051
Less: Values of any property being replaced
Net values upon completion of project
SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER
WASTE CONVERTED AND OTHER BENEFITS AS ESTIMATED ON SB-1 ACTUAL
Amount of solid waste converted
Amount of hazardous waste converted
Other benefits:
SECTION 6 TAXPAYER CERTIFICATION
I hereby certify that the representations in this statement are true.
Signature of authorized represenholve ( Title Date signed(month,day,year)
.-1A7 PIRA C.O . I c' VP Corp Tax 5 ( l 3 j 2DZZ
ii Page 1 of 2
OPTIONAL: FOR USE BY A DESIGNATING BODY WHO ELECTS TO REVIEW THE COMPLIANCE WITH STATEMENT OF BENEFITS(FORM CF-1)
INSTRUCTIONS: (iC 6-1.1-12.1-5.9)
1. Within forty-five(45)days after receipt of this form,the designating body may determine whether or not the property owner has substantially complied with
the Statement of Benefits.
2. If the property owner is found NOT to be in substantial compliance, the designating body shall send the property owner written notice. The notice must
include the reasons for the determination,including the date,time and place of a hearing to be conducted by the designating body. If a notice is mailed to
a property owner,a copy of the written notice will be sent to the county assessor and the county auditor.
3. Based on the information presented at the hearing,the designating body shall determine whether or not the property owner has made reasonable effort to
substantially comply with the Statement of Benefits and whether any failure to substantially comply was caused by factors beyond the control of the
property owner.
4. If the designating body determines that the property owner has NOT made reasonable effort to comply,the designating body shall adopt a resolution
terminating the deduction. The designating body shall immediately mail a certified copy of the resolution to:(1)the property owner;(2)the county auditor,'
and(3)the county assessor.
We have reviewed the CF-1 and find that:
lig the property owner IS in substantial compliance
❑ the property owner IS NOT in substantial compliance
❑ other(specify)
Reasons for the determination(attach additional sheets if necessary)
Signature of auth• a• member , Date signed(month,day,year)
•
Attested by: Designating body
G2£- -n.)Ci}st�� Co.►zntv,tir CovivC fL
If he property owner is found not to be in substantial compliance,the property owner shall receive the opportunity for a hearing.The following date and
time has been set aside for the purpose of considering compliance.
Time of hearing AM Date of hearing(month,day,year) Location of hearing
0 PM
HEARING RESULTS(to be cotnpteted after the hearing)
❑ Approved 0 Denied(see instruction 5 above)
Reasons for the determination(attach additional sheets if necessary) �— —
I i
I �
Signature of authorized member 1 Date signed(month,day,year)
Attested by: Designating body
APPEAL RIGHTS[IC 6-1.1-12.1-5.9(e)]
A property owner whose deduction is denied by the designating body may appeal the designating body's decision by filing a complaint in the office of the
clerk of Circuit or Superior Court together with a bond conditioned to pay the costs of the appeal if the appeal is determined against the property owner.
Page 2 of 2
• 7.,„ COMPLIANCE WITH STATEMENT OF BENEFITS 2022 PAY20z3
71) REAL ESTATE IMPROVEMENTS
State Form 51786(R5/12-21) FORM CF-1/Real Property
Prescribed by the Department of Local Government Finance MAY 8 2022
PRIVACY NOTICE
INSTRUCTIONS: P The cost and any specific Individual's
1. This form does not apply to property located in a residentially distressed area or any ddd r�r t TtY►�U DI TOR salary information is confidential;the
Statement of Benefits was approved before July 1, 1991. balance of the filing is public record
2. Properly owners must file this form with the county auditor and the designating body for their review regarding per IC 6-1.1-12.1-5.3(k)and(I).
the compliance of the project with the Statement of Benefits (Form SS-1/Real Property).
3. This form must accompany the initial deduction application(Form 322/RE)that is filed with the county auditor.
4. This form must also be updated each year in which the deduction is applicable. it is filed with the county auditor
and the designating body before May 18,2022,or by the due date of the real property owner's personal property
return that is filed in the township where the property is located. (IC 6-1.1-12.1-5.3(I))
5. Mth the approval of the designating body,compliance information foe multiple projects may be consolidated on
one(1)compliance form(Form CF-1/Real Properly).
SECTION 1 TAXPAYER INFORMATION
Name of taxpayer County
Premium Brands Services, LLC and ANSA Propco Partnership LP Putnam
Address of taxpayer(number and street,city,state,and ZIP code) DLGF taxing district number
8323 Walton Pkwy, New Albany,OH 43054 67008
Name of contact person Telephone number
Monica Kilgren ( 614 ) 775-3280
•ECTION 2 LOCATION AND DESCRIPTION OF PROPERTY
Name of designating body Resolution number Estimated start date(month,day,year)
Greencastle Common Council 2015-19 Nov 2015
Location of property Actual start date(month,day,year)
1901 State Highway 240, Greencastle, IN 46135 12/1/2015
Description of real property improvements Estimated completion date(month,day,year)
36,300 square foot addition at NW corner of High Bay Dec 2018
Actual completion date(month,day,year)
01/01/2017
SECTION 3 EMPLOYEES AND SALARIES
EMPLOYEES AND SALARIES AS ESTIMATED ON SB-1 ACTUAL
Current number of employees 308 679
Salaries $11,800,000 $25,449,548.80
Number of employees retained 308 308
Salaries $11,800,000 $13,099,881.60
Number of additional employees 30 371
Salaries $998,400 $12,349,667.20
.ECTION 4 COST AND VALUES
COST AND VALUES REAL ESTATE IMPROVEMENTS
AS ESTIMATED ON SB-1 COST ASSESSED VALUE
Values before project $4,521,700
Plus: Values of proposed project $5,000,000 $1,678,800
Less: Values of any property being replaced
Net values upon completion of project $6,200,300
ACTUAL COST ASSESSED VALUE
Values before project $4,530,300
Plus: Values of proposed project $4,695,000 61,630,800
Less: Values of any property being replaced
Net values upon completion of project $6,180,900
SECTION 5 WASTE CONVERTED AND OTHER BENEFITS PROMISED BY THE TAXPAYER
WASTE CONVERTED AND OTHER BENEFITS AS ESTIMATED ON SB-1 ACTUAL
Amount of solid waste converted
Amount of hazardous waste converted
Other benefits:
SECTION 6 TAXPAYER CERTIFICATION
I hereby certify that the representations in this statement are true.
Signature of authorized representative r Title Date signed(month,day,year)
`-1,7\/\__C---wu-t✓o- �,CAL�,„ VP Corp Tax 5 J t 312c ZZ-
0 Page 1 of 2
OPTIONAL: FOR USE BY A DESIGNATING BODY WHO ELECTS TO REVIEW THE COMPLIANCE WITH STATEMENT OF BENEFITS(FORM CF-1)
INSTRUCTIONS: (IC 6-1.1-12.1-5.9)
1. Within forty-five(45)days after receipt of this form,the designating body may determine whether or not the property owner has substantially complied with
the Statement of Benefits.
2. If the property owner is found NOT to be in substantial compliance, the designating body shall send the property owner written notice. The notice must
include the reasons for the determination,including the date,time and place of a hearing to be conducted by the designating body. If a notice is mailed to
a property owner,a copy of the written notice will be sent to the county assessor and the county auditor.
3. Based on the information presented at the hearing,the designating body shall determine whether or not the property owner has made reasonable effort to
substantially comply with the Statement of Benefits and whether any failure to substantially comply was caused by factors beyond the control of the
property owner.
4. If the designating body determines that the property owner has NOT made reasonable effort to comply,the designating body shall adopt a resolution
terminating the deduction. The designating body shall immediately mail a certified copy of the resolution to:(1)the property owner;(2)the county auditor,
and(3)the county assessor.
We have reviewed the CF-1 and find that: — I
(L the property owner IS in substantial compliance
❑ the property owner IS NOT in substantial compliance
❑ other(specify)
Reasons for the determination(attach additional sheets if necessary)
Signature of auth • e ben Date signed(month,day,year)
Attested Designating body
Ga_> cr-ts . Corv'zs to,-I COUSJC/
If he property owner is found not to be in substantial compliance,the property owner shall receive the opportunity for a hearing.The following date and
time has been set aside for the purpose of considering compliance.
Time of hearing ❑AM Date of hearing(mondr.day,year) Location of hearing
❑PM
HEARING RESULTS(to be completed after the hearing)
❑ Approved ❑ Denied(see instruction 5 above)
Reasons for the determination(attach additional sheets if necessary)
1 }
Signature of authorized member — j Date signed(month,day,year)
Attested by: Designating body
APPEAL RIGHTS[iC 6-1.1-12.1-5.9(s))
A property owner whose deduction is denied by the designating body may appeal the designating body's decision by filing a complaint in the office of the
clerk of Circuit or Superior Court together with a bond conditioned to pay the costs of the appeal if the appeal is determined against the property owner.
Page 2 of 2