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EXHIBIT ! <br />TO APPENDIX A <br /> <br />ANNUAL DISCLOSURE REPORT <br /> <br />Region <br /> <br />Con,acc Person** <br /> <br />Phone <br /> <br />Address <br /> <br />J <br />I <br /> <br />Project #~me or Number** <br /> <br />Type of Pro~ecc (PLEASE CIRCLE): <br /> <br />Housing Economic Development <br /> <br />Redevelopment <br /> <br />J <br />i <br /> <br />Fiscal Year: <br /> <br />Adminiscerlng Agency: <br /> <br />Original Assessed Value <br /> <br />I Current Assessed Value <br /> <br />C~pcured Assessed Velue Retelned by the <br /> <br />j Administering Authority <br /> Captured Assessed Value Shred rich Ocher <br /> <br /> Taxing Districts (City, School District, <br />I County, Townships, etc.) <br /> <br />I <br /> <br />Amount of T~x Increment Received During this Period <br />Amount of Outstanding Bond Indebtedness <br /> <br />$ <br /> <br />$ <br /> <br />J <br /> <br />l-&-I _ <br /> <br /> <br />