HomeMy Public PortalAbout09 - 2022-9 - CROWN EQUIPMENT COMPLIANCE WITH STATEMENT OF BENEFITS RESOLUTION NO. 2022 -9
COMMON COUNCIL OF THE CITY OF GREENCASTLE, INDIANA
A RESOLUTION AFFIRMING
CROWN EQUIPMENT CORPORATION
OF COMPLIANCE WITH STATEMENTS OF BENEFITS
WHEREAS, Crown Equipment Corporation 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 expansion granted in 2011,
CF-1/RE for tax abatement on a facility expansion granted in 2017,
CF-1/PP for tax abatement on equipment granted in 2011, and
CF-1/PP for tax abatement on equipment granted in 2017.
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 Crown Equipment Corporation.
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
„6/'
Adam C en ody , ert
Ad) /
M ammer 'tame gdo i
,G:
D i urr y - onica
Darrel Thomas
Approved and signed by me this 7th day of July 2022 at 7; p.m. o'clock.
ATTEST: illiam ory, Jr., Mayor
Lynda . Dunbar, Clerk-Treasue
„� COMPLIANCE WITH STATEMENT OF BENEFITS PRIVACY NOTICE FORM CF-1 /PP
°�` PERSONAL PROPERTY This form contains confidential
State Form 51765(R5/1-21) information pursuant to IC1, 2022
IC 6-1.1-35-9 and IC 6-1.1-12.1-5.6. January
= Prescribed by the Department of Local Government Finance
EIVED
RTECQ/va. 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)
MAY 1 22ZOns 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 file between
January 1 and the extended due date of each year.
Y Iproval of the designating body, compliance information for multiple projects may be consolidated on one(1)compliance
PI AM COU NA
•ECTION 1 TAXPAYER INFORMATION
Name of taxpayer County
Crown Equipment Corporation Putnam
Address of taxpayer(number and street,city,state,and ZIP code) DLGF taxing district number
44 South Washington Street, New Bremen, OH 45869-1247 008
Name of contact person Telephone number
Cher 1 Christensen (419) 629-2311
.ECTION 2 LOCATION AND DESCRIPTION OF PROPERTY
Name of designating body Resolution number Estimated start date(month,day,year)
Greencastle City Council 2011-2, 2011-4 04/01/2011
Location of property Actual start date(month,day,year)
2600 State Road 240, Greencastle, IN 46135
Description 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.
03/31/2013
Actual completion date(month,day,year)
ECTION 3 EMPLOYEES AND SALARIES
EMPLOYEES AND SALARIES AS ESTIMATED ON SB-1 ACTUAL
Current number of employees 302 753
Salaries 12, 546, 000 33, 163, 654
Number of employees retained 302 302
Salaries 12, 546, 000 12, 546,000
Number of additional employees 14 3 451
Salaries
5, 934, 000 20, 617, 654
.ECTION 4 COST AND VALUES
MANUFACTURING
R&D EQUIPMENT LOGIST DISST. IT EQUIPMENT
EQUMENTCOST ASSESSED ASSESSED ASSESSED ASSESSED
AS ESTIMATED ON SB-1 VALUE COST VALUE COST VALUE COST VALUE
Values before project 10,339,252
Plus: Values of proposed project 10,950,000
Less: Values of any property being replaced
Net values upon completion of project 21,289,252.00
ACTUAL ASSESSED ASSESSED ASSESSED ASSESSED
COST VALUE COST VALUE COST VALUE COST VALUE
Values before project 10,339,252
Plus: Values of proposed project 24,751,278
Less: Values of any property being replaced
Net values upon completion of project 35,120,530.00
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.
Sign re of authori presentative Title Date signed(month,day,year)
/4/44-1.(/71n_ Tax Manager 5/4/2022
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:
([g 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 bar_(J//
Date signed(month,day,year))
Attested by: ` -- "J J L *
Designating body
G2£ c:tsfl� CorV(r►•rosi Cnv;JciL
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 1 Date of hearing(month.day,year) Location of hearing
_DIM
HEARING RESULTS(to be cotnpfeted after the hearing)
❑ Approved ❑ Denied(see instruction 5 above)
Reasons for the determination(attach additional sheets if necessary)
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 bodys 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
„T'4'), COMPLIANCE WITH STATEMENT OF BENEFITS PRIVACY NOTICE FORM CF-1 /PP
'• •-• • s PERSONAL PROPERTY This form contains confidential
State Form 51765(R5/1-21) information pursuant to January1, 2022
IC 6-1.1-35-9 and IC 6-1.1-12.1-5.6.
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 1C 6-1.1-3.7 has been granted. A person who obtains a filing extension 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
•ECTION 1 TAXPAYER INFORMATION
Name of taxpayer County
Crown Equipment Corporation Putnam
Address of taxpayer(number and street,city,state,and ZIP code) DLGF taxing district number
44 South Washington Street, New Bremen, OH 45869-1247 008
Name of contact person Telephone number
Cher 1 Christensen (419) 629-2311
.ECTION 2 LOCATION AND DESCRIPTION OF PROPERTY
Name of designating body Resolution number Estimated start date(month,day,year)
Greencastle City Council 2017-4, 2017-5 03/01/2017
Location of property Actual start date(month,day,year)
2600-2601 State Route 240, Greencastle, IN 46135
Description 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.
12/31/2023
Actual completion date(month,day,year)
•ECTION 3 EMPLOYEES AND SALARIES
EMPLOYEES AND SALARIES AS ESTIMATED ON SB-1 ACTUAL
Current number of employees RE^(��•-'�/CG 6 6 7 753
Salaries L V 28, 483, 620 33, 163, 654
Number of employees retained 6 67 6 67
Salaries MAY 12 2022 28, 483, 620 28, 483, 620
Number of additional employees
Salaries PUTNAM COUNTY AUDITOR 4 409, 600 4, 680, 034
.ECTION 4 COST AND VALUES
MANUFACTURING R&D EQUIPMENT LOGIST DIST IT EQUIPMENT
EQUIPMENT EQUIPMENT
COST ASSESSED ASSESSED ASSSS
AS ESTIMATED ON SB-1 VALUE COST VALUE COST VALUE SESSED AE
COST VALUSEDE
Values before project 30,704,307
Plus: Values of proposed project 10,000,000
Less: Values of any property being replaced
Net values upon completion of project 40,704,307,00
ASSESSED ASSESSED ASSESSED ASSESSED
ACTUAL COST VALUE COST VALUE COST VALUE COST VALUE
Values before project 30,704,307
Plus: Values of proposed project 4,416,223 '
Less: Values of any property being replaced
Net values upon completion of project 35,120,530.00
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.
Signatur of authori ed r sentative Title Date signed(month,day,year)
�� •fit i,.” Tax Manager 5/4/2022
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
D the property owner IS NOT in substantial compliance
0 other(specify)
Reasons for the determination(attach additional sheets if necessary)
Signature of auth• • e• member A , Date� signed(month,day,year)
Attested by: `J(/1J JJL 'TONZd-2-Z
Designating body
!�-- / G2Efi-n)ctts J L, Coinin43 J CLIt'W 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 a Date of hearing(month.day,year) Location of hearing
_..-❑PM _-_ --- —
HEARING RESULTS(to be completed after the hearing)
❑ Approved 0 Denied(see instruction 5 above)
Reasons for the determination(attach additional sheets if necessary) — -
Signature of authorized member I 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 i
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
•
�E
�, 0;,RS_Aq. COMPLIANCE WITH STATEMENT OF BENEFITS so 22 PAY 2o23
‘f,: REAL ESTATE IMPROVEMENTS RE
.i F: `" �� _
D FORM CF-1 /Real Property
: :; State Form 51766(R5/12-21)
Prescribed by the Department of Local Government Finance MAY 1 2 2022
PRIVACY NOTICE
INSTRUCTIONS: P �TNA� The cost and any specific individuals
1. This form does not apply to property located in a residentially distressed area or any 8eThJdt1Fl fo NTX AUDITOR salary information Is confidential;the
Statement of Benefits was approved before July 1, 1991. balance of the filing is public record
2. Property 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 SB-1/Real Property).
3. Thls 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,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(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
Crown Equipment Corporation Putnam
Address of taxpayer(number and street,city,state,and ZIP code) DLGF taxing district number
44 South Washington Street, New Bremen, OH 45869-1247 008
Name of contact person Telephone number
Cheryl Christensen (419 ) 629-2311
SECTION 2 LOCATION AND DESCRIPTION OF PROPERTY
Name of designating body Resolution number Estimated start date(month,day,year)
Greencastle City Council 2011-2, 2011-4 04/01/2011
Location of property Actual start date(month,day,year)
2600 State Route 240
Description of real property improvements Estimated completion date(month,day,year)
11/01/2011
Actual completion date(month,day,year)
09/24/2012
SECTION 3 EMPLOYEES AND SALARIES
EMPLOYEES AND SALARIES _ __ AS ESTIMATED ON SB-1 ACTUAL
Current number of employees 302 753
Salaries 12,548,000.00 33,163,654.00
Number of employees retained 302 302
Salaries 12,546,000.00 12,546,000.00
Number of additional employees 143 451
Salaries 5,934,000.00 20,617,654.00
SECTION 4 COST AND VALUES
COST AND VALUES REAL ESTATE IMPROVEMENTS
AS ESTIMATED ON SB-1 COST ASSESSED VALUE
Values before project 7,194,189.00
Plus: Values of proposed project 6,500,000.00
Less: Values of any property being replaced
Net values upon completion of project 13,694,189.00
ACTUAL COST ASSESSED VALUE
Values before project 7,194,169.00
Plus: Values of proposed project 15,552,400.00
Less: Values of any property being replaced
Net values upon completion of pro'ect 22,746,589.00
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.
Signet re of authoriz re resentative Title Date signed(month,day,year)
Tax Manager 5/4/2022
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• e• me ber Date signed(month,day,year)
drV .1) �*
Attested by: —
Designating body
s � Co nv[rvro, Coc,i:jc t L 1
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
❑ PMI
HEARING RESULTS(to be completed after the hearing)
❑ Approved ❑ 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: 1 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 bodys 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
>s COMPLIANCE WITH STATEMENT OF BENEFITRECEIVED 2022 PAY2023
a ;` �i> REAL ESTATE IMPROVEMENTS
` State Form 51766(Rb/12-21) FORM CF-1 /Real Property
Prescribed by the Department of Local Government Finance MAY 12 2022
PUTNAM COUNTY AUDITOR PRIVACY NOTICE
INSTRUCTIONS: The cost and any specific individual's
1. This form does not apply to property located in a residentially distressed area or any deduction for which the salary information is confidential;the
Statement of Benefits was approved before July 1, 1991. balance of the filing is public record
2. Property 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 SB-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 16,2022,or by the due date of the real properly owner's personal property
return that is filed in the township where the property is located. (iC 6-1.1-12.1-5.30))
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
Crown Equipment Corporation Putnam
Address of taxpayer(number and street,city,state,and ZIP code) DLGF taxing district number
44 South Washington Street, New Bremen,OH 45869-1247 008
Name of contact person Telephone number
Cheryl Christensen (419 ) 629-2311
•
SECTION 2 LOCATION AND DESCRIPTION OF PROPERTY
"Nam of.esignating body Resolution number Estimated start date(month,day,year)
Greencastle City Council 2017-4, 2017-5 03/01/2017
Location of property Actual start date(month,day,year)
2600-2601 State Route 240, Greencastle
Description of real property improvements Estimated completion date(month,day,year)
03/01/2022
Actual completion date(month,day,year)
SECTION 3 EMPLOYEES AND SALARIES
EMPLOYEES AND SALARIES _ AS ESTIMATED ON SB-1 ACTUAL
Current number of employees 667 753
Salaries 28,483,620.00 33,163,654.00
Number of employees retained 667 667
Salaries 28,483,620.00 28,483,620.00
Number of additional employees 100 86
Salaries 4,409,600.00 4,680,034
SECTION 4 COST AND VALUES
COST AND VALUES REAL ESTATE IMPROVEMENTS
AS ESTIMATED ON SB-1 COST ASSESSED VALUE
Values before project 17,834,427.00
Plus: Values of proposed project 1,000,000.00
Less: Values of any property being replaced
Net values upon completion of project 18,834,427.00
ACTUAL COST ASSESSED VALUE
Values before project 17,834,427.00
Plus: Values of proposed project 4,912,162.00
Less: Values of anyproperty being replaced
Net values upon com•letlon of project 22,746,589.00
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 certifty that the representations in this statement are true.
Signatu e of authorized r entative Title Date signed(month,day,year)
Tax Manager 5/4/2022
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 properly 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 ji
Date signed(month,day,year)
Attested by: v
Designating body
G2£> cP}S IL Co Min 0Ai (JJ I /
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
I time has been set aside for the purpose of considering compliance.
Time of hearing ❑AM Date of hearing(month.day,year) Location of hearing A I
❑PM I
HEARING RESULTS(to be completed after the hearing)
❑ Approved ❑ Denied(see instruction 5 above)
Reasons for the determination(attach additional sheets if necessary)
(
}
}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