GEORGE STONE
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91030096
WARRANTY DEED
I JU~N;.~,!~l;~!~ 6 ~~ ~ ~fr1,. u
lhis Wart'aRty Drrd-J~;(I";1' lIt!' / 2 0 th
GEORGE W. STONE, a./ married man, individually and as Successor Trustee
of the J.O. STONE GRANDCHILDREN'S TRUST dated December 29, 1976 as a surviying
',,'rei/lUfll'r called II", W((1I10f 10 parttner hO~ SKYLARK OPPORTIJNITIES, a Florida general
, , par ners lP
CITY OF CLEARWATER, FLORIDA
'. PINELLAS COUNTY FLA.
IoFF . REC. BK 7604m P(J__~;:5Zf?
IN01VID. TO INDIVlD
d((y of
June,
1\, f) 1<)
91 l)y
I/IllOSI' /losloffice address is P.O. Box 4748, Clearwater, Florida 34618-4748
/"'/'I'i/lo!I,'r culled IIII' flm/ll(>e:
(\Vherf>\,{'r ll\C'd h('n~ill th" t('rlll~. "Io(rantor" and "'(fallin'" include all the partie'i to this in!i.trument and
tht" hrirs. 1('l(al r('pr(''''f'lltatj\'(.~ and a.....i~n~ or individuals. and the .'iuc('e"sors and a"si_~ns or corporations)
Uitnesseth: TII(lI III(' W((/lIOf, for amI ill cOllsic!l'rnfio/l of III(' slim of $ 10.00 alld oIlier
I'ullla/)I(. considemfions, r('('('ipl 1/1l.er('of is I,erel)y ack/lOfl.l(.dr/f'd, 1,('relJY Wa/lIs, l)(lrflaills, sells, ali(>ns, re-
mises. rell'nses, cOlll'eys nml confirms urllo 111(> (/,,11I lee, ull 111((1 c('r/nill Iml<l silllatl' in Pinellas
Cowlly, Florida, (liz:
Lot 4, JANIE DANIELS SUBDIVISION, according to the plat thereof, as recorded
in Plat Book 5, Page 23 of the Public Records of Pinellas County, Florida.
parcel number 15/29/15/29286/000/0040
Grantors social sec. II /
489-20-1935
(GEORGE)
(TRUST NO.)
\(~
.,:CfDCl:X:
59-6617.57.0
- ~ ~ -:' 'n '!!~,
DocumentAry Tax Pe1. ~~' ~,Q()
-- _.-....-c..n......
$
,i-r_< t _____ _.__....~.
i):,; .--..------
------ ~;r,~,..,.~.~~jl.: ';-3:~ Pd.
k:.}1';..'
K1rI3f;" F, 9~!;'f'" r;,il:'<" ..,"....ty
W ,~C, ~-",_,l
By _ r;;~,.ulf Cisrk
F)~ /l5r;r;t::(t)
~_r- with
wise nppertaining,
To Ilalle and to Ilold, the same in fee simple forever,
all the tenements, hereditaments and appurtenances thereto belonging or in any-
llnd tlte grantor hereby covenants with said grantee that Ihe grantor is lawfully seized of said land
in fee simple; that the grantor has good right and lawful authority to sell and convey said land; that the
grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of
all persons whomsoever; and that said land is free of all encumbrances, except taxes accruing subsequent
10 ~ June 24, 1991 and easements and restrictions of record.
KARLEEN F. DEBLAKE~ C~
REQ.QRJ~mYE:BJFII::J~_ BY:
In ltJilness ltfhereof, the said grantor has signed and sealed these presents the day and year
first above written,
Signed, sealed and delivered in our presence:
'~ uuu:s~ria~~u:
/
'G"
I HEREBY CERTIFY that on this day, before me, an officer duly
authorized in the State aforesaid and in the County aforesaid to take
acknowledgments, personally appt'ared
GEORGE W. STONE, a ./ married man, indivi
and as Successor Trustee of the J.O. STONE G
TRUST, dated December 2Q, 1976 as a survivinQ nar
to me known to bet,he pt'rson described in and wno ext'cutt'd-Cfhe-
foregoing instru~l\~,,(~);ilal.;;.~;ib-e acknowledged before me that he
executed the,.~"r\::',\'~.,.. ,';'':,
'~,Jv,J''f~ss "~<h~r~,..,~nd official st'a.!, in the County and
. "'-, )-lat~ast a~es';"'t~}S / Dt 0 day of
:.:;.' 9 li(f. V ~ .~ ~W . A, D, 19 91
-~<i'~fi1~DA
T'/l1'r InslrtJJ/'l'r.'tpS:tptlred1'...\'-, MY COMMISSION EXPIRES: ./
'1 dd "H '," ~ .-tro1(C. sta!a of Aortaa L_
, Ie. ~J ~~ic:1 Expires NOV 0.. 11.8
ually
ILDREN'S
ner of SKYLARK OPPORTUNITIES,
Florida general partnership
fl" ftuLn,-b "
(\'1:.',- , ~" .,
This Imlrument Win rICp'llre_lJ.\.'
~o'.'~""'," H'f Tll'l r. 01' C;,,':AR ,,;' A fER
:-i ~ ~:. "~I ", '" ' ,"" ERM1\IN
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RONALD (RON) E, SOMERS
President
STE'VAR'I' TI'rLI~~
OF CLEARWATER
p,o, Box 2756
Clearwater, Florida 34617
(813) 441-2689
1290 Court Street
Clearwater. Florida 34616
D I S C LOS U R E
We, the Owners of that certain real property located at
rm 4, JANIE DANIELS SUBDIVISION
Pinellas County, Florida, do hereby disclose the following facts
known to me which may materially affect the value or desirability
of said property.
I HEREBY CERTIFY that I have no knowledge of any facts or
defects in said property which may materially effect the value or
desirability of said property, except as set forth above. I
acknowledge that this disclosure will be given to the listing
broker, the selling broker, and any prospective buyer.
~
U~ ~""U_ ~u ~-.. ~& -
. Wi tness
CD
-
/~c.~/
ess
STATE OF
FLORIDA
COUNTY OF
PINELLAS
G)
SWORN' 'TO AND SUBSCRIBED BEFORE ME THIS~ dO
DAY OF
JUNE
19
91.
@v
My Commission Expires:
AJou ~JqCJI
@ <-:~ 01 JJ"nuJ-m
Notary Public
~
V'
(-~'
'j? G\\
INFORMATION lOR REAL ESTATE 1099-S REPORt "FILING
Section 6045 of the Internal Revenue Code, as amended by the Tax
Reform Act of 1986, requires the reporting of certain information on
every real estate transaction. From the information you provide
below, a Form 1099-S will be produced, a copy of it will be furnished
to the I.R.S. and to you no later than January 31 of the next year,
and a copy may be sent to other third parties. If you fail to furnish
adequate information (in particular, a taxpayer ID number), then you
will be subject to all I.R.S. Regulations, including the possible
withholding of twenty percent (20%) of the current sales price.
..
91030096
File Number:
Taxpayer ID Number:Seller 1 ~59-6612520
Seller 2
Taxpayer ID Type:
2
~1 = business, 2 = individual)
SELLER 1 NAME:
TRUST
Last: J .0. STONE GRANDCHILDREN'S First & Middle:
SELLER 2 NAME:
Last:
First & Middle:
MAILING ADDRESS (as of January 31 of next year)
SELLER 1:
Street:,/' ao3CIJ ~
C it y iL C t. efLr-.J-'-c.r
$) '" \\1 It
state:~rL.
Zip code:~
SELLER 2:
Street:
City:
State:
Zip Code:
TRANSACTION INFORMATION
Closing Date (MMDDYY):
JUNE 24, 1991
Contract Sales Price: Seller 1 -
~ 22,SOO.OO
Seller 2 -
(If multiple sellers please allocate the sales price among the sellers)
Description of Property:
Street Address:
Legal Description: LCJl' 4, JANIE DANIELS SUBDIVISION
Under penal ties of perjury, I, J .0. S'IONE GRANDCHILDREN'S TRUST
(Name of Seller (s))
certify that the number shown on this form is my correct, Taxpayer
Identification Number and that the other information is correct to the
best of my understanding and I understand that it will appear on a Form
1099-S that will be sent to me and to the Internal Revenue Serv'ce.
Date:
Seller - 2
, W...
, SUCCESSOR TRUSTEE
Date:j/""'June 20,1991
Seller - 1
CLOSING AGENT INFORMATION (to be completed by closing agent)
Name:
STEWART TITLE COMPANY OF CLEARWATER, INC.
Mailing Address:
1290 COURT STREET
City:
CLEARWATER
State:
FL
Zip Code: 34616
Taxpayer ID Number:
59-1433918
l .';
INFORMATI!N FOR REAL ESTATE 1099-s RJpORT' FILING
Section 6045 of the Internal Revenue Code, as amended by the Tax
Reform Act of 1986, requires the reporting of certain information on
every real estate transaction. From the information you provide
below, a Form 1099-S will be produced, a copy of it will be furnished
to the I.R.S. and to you no later than January 31 of the next year,
and a copy may be sent to other third parties. If you fail to furnish
adequate information (in particular, a taxpayer ID number), then you
will be subject to all I.R.S. Regulations, including the possible
withholding of twenty percent (20%) of the current sales price.
File Number:
91030096
Taxpayer ID Number:Seller 1 ~59-6612520
Seller 2
Taxpayer ID Type:
2
,(1 = business, 2 = individual)
SELLER 1 NAME:
'!RUST
Last: J .0. S'IONE GRANDCHILDREN" S First & Middle:
SELLER 2 NAME:
Last:
First & Middle:
MAILING ADDRESS (as of January 31 of next year)
SELLER 1:
Street:./' .03' A~ 0,,\\18:
City i.L C ~C-..rtJocl-,,.. State:v- FL.
Zip Code:~
SELLER 2:
Street:
City:
State:
Zip Code:
TRANSACTION INFORMATION
Closing Date (MMDDYY):
JUNE 24, 1991
Contract Sales Price: Seller 1 -
15,000.00
Seller 2 -
(If multiple sellers please allocate the sales prlce among the sellers)
Description of Property:
Street Address:
Legal Description: La!' 4, JANIE DANIELS SUBDIVISION
Under penal ties of perjury, I, J .0. S'IONE GRANDCHILDREN'S '!RUST
(Name of Seller (s))
certify that the number shown on this form is my correct Taxpayer
Identification Number and that the other information isjcorrect to the
best of my understanding and I understand that it will appear on a Form
1099-S that will be sent to me and to the Internal Revenue Serv'ce.
Date:
Seller - 2
, W,
, SUCCESSOR '!RUSTEE
Date:/./""June 20, 1991
Seller - 1
CLOSING AGENT INFORMATION (to be completed by closing agent)
Name: STEWART TITLE ca-1PANY OF CLEARWATER, INC.
Mailing Address: 1290 COURT STREET
City: CLEARWATER State: FL Zip Code: 34616
Taxpayer 10 Number: 59-1433918
I
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.t..,,,,,'ht. ,,/ f:orJlrnt..t
RONALD (RON) E, SOMERS
President
s"rEWAIl."r "rI"rLE
OF CLEARWATER
P,O, 80x 2756
Clearwater, Florida 34617
(813) 441-2689
1290 Court Street
Clearwater, Florida 34616
AUTHORIZATION AND ACKNOWLED:;EMENT FORM
Reference:
FILE NO.
91030096
LEGAL
LOT 4, JANIE DANIELS SUBDIVISION
SELLER
GEORGE W. S'IDNE
BUYER
We hereby approve and acknowledge receipt of a copy of the Statement and actual
cost (DISCLOSURE/SE'ITI.EMENT STATEMENT - HUD FD~ and authoriz~ disbursement
of funds as shown therein this 24 day of E , 19_. We further
acknowledge that we understand utility bills are not included in this staten~nt
and that the proration of taxes as shown in the statement of actual cost is
based on the latest infonnation available. If any changes are to be made in this
proration when the tax bill is received, it will be handled between the parties of
this transaction. Stewart Title Company of Clearwater, Inc., will not be held
responsible. It is further understood that Stewart Title Company of Clearwater,
Inc., cannot, at this time, assertain if there will be personal property tax on
subject property or an amount on which to base a proration. Any proration necessary
when tax bills become available will be handled between the parties to this
transaction, outside of Stewart Title Company Company of Clearwater, Inc.
Stewart Title Company of Clearwater, Inc., will be not held responsible.
~w\~
SUCCESSOR TRUSTEE
SELLER'S FDRWARDING ADDRESS:
BUYER 1 S FDRWARDING ADDRESS:
~O\03<=\ A.s~~RIV'C..
vfj -c~r..vo..+ c: r) FL d"lb614
HCX'1E PHONE# d(&),3:> S.3 tJ - 7., OlJ
VlDRK PHONE# /< ,,.;) I -5")3- '1'S ~
HCX'1E PHONE#
WORK PHONE#
'!HIS IS TO FURTHER AUTHORIZE
CHANGES NECESSARY TO THE CLOSING STATEMENT.
TO APPROVE ANY
STEWART TITLE COMPANY OF CLEARWATER, INC.
BY:
. '
I
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NON-FOREIGN CE.HTU'ICNl'ION BY INDlVIDUl\L THl\NSF'EHOR
1. Section 1445 of the InLernal Revenue C(x]e provides that a trilt,lSferee ;:.[ a United
States real property interest must withhold tax if the transferor is iJ foreign person.
2.
In order to infonl Lhe truns[eree Lhut withholding o[Lax is not required upon
dis[X)sJUon by GEORGE W. ,S'IDNE, SUCCESSOR TRUSTEE OF THE J .0. STONE
GRANDCHILDREN'S TRUST
of the United States reul property described as follows:
the
1m 4, JANIE DANIELS SUBDIVISION
the undersigned transferor certifies and declares by means of this certification, the
following:
(a) I (We) am (are) not non-resident alien(s) for purposes of United States income
taxa tion uncl,
(b) My United States taypaper identifying lllllnber(s) (Social Security Number) is/are:
Nl\ME SOCIl\L Sr,cURI'lY NUMDER
Ci)
GEORGE W. S'IDNE , SUCCESSOR TRUSTEE fI"....- ..., 1 · a p ... ,..&S'
n
n
fI
(c) My home mldress is
(attached additional page if Ilccessur.y)
(el) There are no othel~ persons who huve an owneJ~ship interest in the uoove-descd,eed
property othor than those persons set forth above in subparagraph (b).
3. '.l.l1e undersigned hereby further certifies and declares:
(a) I (We) understand that the plrchaser of the aoove described property intends
to rely on the foregoing representati.ons in connection with the Uniteel States
P'oreign Investment in Real Property 'l'ax l\ct. (94 Statute 2602 as alllendecl).
(b) I (Wl}) ulIdersltllld this certification Hay l~ disclosed to the Internal Revenue
Service by transferee and that any false statement contained in this certification
ll1ilY be p"llished by Hl1e, imprisollment or tDtll.
Under penalties of
fication and it is
(3) v
Date JUNE
perjury I (we) declare I (we) have examined carefully this certi-
true, correct and complete.
1991
at PINELIAS
~t,
('l11 document must be ret ned until the end of the fifth taxable year following the"
taxable year in which the transfer takes place).
CONSUL'l' YOUR l\'l'l'ORNEY l\NO/On 'I'l\X l\OVISOn - NO HEPHESE.'NTl\'rION on HECOMMENDl\TION IS Ml\DE BY
STEWART 'l'I'l'LE INSlJH1\NCE COOPANY AND/OR CONCERNING TIlE
LEGl\T.J SUFFICIENCY AND/OR 'l'l\X CONSQUI!''NCES Qli' 'tHIS IXnJ~mN'l'. YOU Ml\Y DE HEQUIImJ '1'0 FILE
l\ COpy OF TIlTS DOCtJMI;;Nl' W:J'l1I 'l'(JI~ IN'l'ERNl\T, ntWI!:N{JI~ SlmVICE. '.I1IE:SE l\RE QUESTIONS FOR YOun
l\'rl'()nNI~ on Tl\X AlJVlSOIL
S'l'l\'l'E OF FLORIDA
COUN'lY OF PINELLAS
I HEREBY CI~H'l'n"Y that on this day, before me, an officer duly authorized in the State
aforesaid and in the County aforesaid to take acknowledgments, personally ilppeared
GEORGE W. S'IDNE
to me known to be the persons described in and who executed the foregoing instrument
and they acknowledged before me that they executed the same. (:(2.-
WITNESS my hand and official seal in the County and State last aforesaid this cJ Q' day
of Ci'~ ,19 91 . (0 L~d 1-fdJL<-k.
,/' \ 'NOl'l\RY PUULIC (7i'. __
,--{! 0- MY Cot-f1ISSION EXPIRES :~tJ ~ /9 9'
County,
FLORIDA
,~~~ ----
NE, SUCCESSOR TRUSTEE
. .. \
Iro BE FILLED IN PERSONAlLY"
BY SELLER OR BORROWER IN HIS OWN HANDWRITING
INDEMNITY AND AFFIDAVIT AS TO DEBTS, LIENS, AND POSSESSION
USE SEPARATE FORM FOR EACH PARTY
GEORGE W. S'IDNE
Seller OJ: Owner-Borrower
LOT 4, JANIE DANIELS SUBDIVI~ION
Contractor (if new construction)
Purchaser
personally known to me to be the person whose name is subscribed hereto, and upon his oath deposes and says:
I, the seller, owner-borrower, and/or contractor, represent to the purchaser and/or lender in this transaction
that to my knowledge there are:
1. No unpaid debts for plumbing fixtures, water heaters, floor furnaces, air conditioners, radio or television an-
tennae, carpeting, rugs, lawn sprinkling systems, venetian blinds, window shades, draperies, electric appliances,
fences, street paving, or any personal property or fixtures that are located on the subject property described
above, and that no such items have been purchased on time payment contracts, and there are no security
interests on such property secured by a financing statement, security agreement or otherwise except the
following: (If none, so state.)
NAME AND ADDRESS OF SECURED PARTY (i) Approximate Amount
..-/ none
.
2. No loans of any kind on said property except the following: (If none, so state.)
NAME AND ADDRESS OF CREDITOR @ Approximate Amount
_ ~ none
3. All labor and material used in the construction of improvements or repairs on the above described property
have been paid for and there are now no unpaid labor or material claims against the improvements or the
property upon which same are situated, and I hereby declare that all sums of money due for the erection of
improvements or repairs have been fully paid and satisfied, except: (If none, so state.)
NAME AND ADDRESS OF SUPPLIER OF LABOR, SERVICES OR MA TERIALS is Approximate Amount
'~ none
4. I, the purchaser, represent that I have no knowledge of any debts or liens of any kind other than those listed
above, except: (If none, so state.)
NAME AND ADDRESS OF SECURED PARTY, CREDITOR, SUPPLIER OF
LABOR OR MATERIALS Approximate Amount
5. I, the owner-borrower, or purchaser, have not been given notice of the furnishing or intent to furnish any labor,
services, or materials in connection with any improvements or repairs to said property from any person or firms,
except: (If none, so state.)
SUPPLIER OR LABOR, SERVICES OR MATERIALS ADDRESS
6. I, the undersigned owner, further certify thta.t the real estate and personal property above described are in the
actual possession of the undersigned and is not in the possession, actual or constructive, of any person, persons,
or organizations holding or claiming same, adversely to the undersigned under contract, lease, or any other color
of title or right of possession,
The improvements or repairs to said property are now completed and have been accepted by purchaser and/or
owner-borrower. ,
INDEMNITY: I, THE SELLER, OWNER-BORROWER, AND/OR CONTRACTOR, AGREE TO PAY ON DEMAND
TO THE PURCHASERS AND/OR LENDER IN THIS TRANSACTION, THEIR SUCCESSORS AND ASSIGNS, ALL
AMOUNTS SECURED BY ANY AND ALL LIENS NOT SHOWN ABOVE, TOGETHER WITH ALL COSTS, LOSS
AND AlTORNEY'S FEES THAT SAID PARTIES MAY INCUR IN CONNECTION WITH SUCH UNMENTIQNED
LIENS, PROVIDED SAID LIENS EITHER CURRENTLY APPLY TO SUBJECT PROPERTY, OR A PART THERE-
OF, OR ARE SUBSEQUENTLY ESTABLISHED AGAINST SAID PROPERTY AND ARE CREATED BY ME,
KNOWN TO ME OR HAVE AN INCEPTION DATE PRIOR TO THE CONSUMMATION OF THIS TRANSACTION.
I realize that the purchaser and/or lender in this transaction are relying on the representation contained herein in purchasing
..'.',.'..'.. ~DLf.dbl. m..ey th~.t"'1d would .ot purch... sam. 0' I..d mo..y the..o. u.I... saKi "p.....tat;o.. we" made,
('IV ~ 1l9-J.~
G OH W. NE, SUCCESSOR TRUSTEE , __
(5,~0l
SWORN TO AND S~UBSCIBED BEFORE ME THis () day of
Gd ~~ ' / I --I-.!l.. A (;j,v; 1 ,I 8/()Oj
~ ~ H~~~ FLORID" My Commission. Expires:,...lJ.. /0 v '/ 7 I.
Notary Public in and for PlNELLAS County, ~ e.-- t(~) I '
NOTE: This form is 10 be .i..,ed by sellor in case of oale, If no ..... il illO be .ilfted by lhe owner.bo"ower, If lheft is any new coMlruction, Iho oonlra<lo, mUll also join in Ihis form
or .i~ . separate one.
JuNE
91
,19_.
Rev, 1/88