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RESIDENTIAL EXTERIOR IMPROVEMENT GRANT AGREEMENT - NG-R-25-19RESIDENTIAL EXTERIOR IMPROVEMENT GRANT AGREEMENT NG -R-25-19 This Residential Exterior Improvement Grant Agreement (this "Agreement") is made as of A/6111 x'1,10 (the "Effective Date"), by and between THE COMMUNITY REDEVELOPMENT AGENCY OF THE CITY OF CLEARWATER, FLORIDA, a public body corporate and politic of the State of Florida created pursuant to Part III, Chapter 163, Florida Statutes (the "Agency"), and Curlene Townsend, an individual (the "Applicant ")(collectively the Agency and the Applicant are the "Parties"). WITNESSETH: WHEREAS, the Agency was created to implement community redevelopment activities as provided in the Florida Community Redevelopment Act of 1969 (the "Act") codified at Chapter 163, Part III, Florida Statutes; and WHEREAS, on January 12, 2023, the Agency adopted. the North Greenwood Community Redevelopment Area Plan (the "Plan"); and WHEREAS, in furtherance of the Plan, the Agency has established the Residential Exterior Improvement Grant Program (the "Program") to rehabilitate single-family homes, improve property conditions, aesthetics, reduce housing cost burden, and aid in the elimination of slum and blight in the North Greenwood Community Redevelopment Area (the "Redevelopment Area"); and WHEREAS, the Agency has approved a grant to the Applicant in an amount not to exceed $13,635.00 in financial assistance under the Program to provide exterior improvement assistance to the property located at 806 Engman Street, Clearwater FL 33755 (the "Property"). The grant is intended to remove and haul away a tree as well as driveway and electrical panel replacement at the Property (the "Project") as further detailed in the Applicant's grant application and plan specifications attached hereto as Exhibit "C" (the "Specifications"); and WHEREAS, the Agency finds that providing financial assistance for the exterior improvement of the Property is a permissible use of the Agency's funds; and WHEREAS, the Agency finds that the Project comports with and furthers the goals, objectives, and policies of the Plan. NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the Parties hereby agree as follows: I. GENERAL 1. Recitals. The foregoing recitals are true and correct and are incorporated in and form a part of this Agreement. 2. Purpose of Agreement. The purpose of this Agreement is to further the implementation of the Plan by the completion of the Project. 1 3. Legal Description. The legal description for the Property is attached hereto as Exhibit "A". II. APPLICANT WARRANTIES AND RESPONSIBILITIES 1. Development of the Project. The Applicant shall complete the Project in accordance with the Specifications and the grant application. The Applicant shall complete all Project work within one hundred and eighty (180) days from the date of application approval. Such completion shall be evidenced by receipt of a Finding of Project Completion from the Agency. A Finding of Project Completion shall be granted in accordance with the criteria contained in the Agency's Residential Exterior Improvement Grant Policy attached hereto as Exhibit "B" (the "Policy"). The date of application approval shall be the Effective Date. 2. Applicant's Project Contribution. As a condition of receiving reimbursement grant funding from the Agency, the Applicant shall provide three thousand thirty dollars and 00/100 cents ($3,030.00) in monetary contribution (the "Monetary Contribution") toward the Project. Evidence of expenditure of the Monetary Contribution towards the Project shall be submitted to the Agency's satisfaction before disbursement of the Agency's grant funding. Notwithstanding the foregoing, the Applicant may have the Monetary Contribution reduced if the Applicant completes certain community service acts in accordance with the Policy. The Applicant has agreed to complete eleven (11) hours of community service ("Hours") reducing the Monetary Contribution to one thousand five hundred fifteen dollars and 00/100 cents ($1,515.00) (the "Reduced Contribution"). In the event the Applicant is unable to provide the number of Hours agreed to herein, the Reduced Contribution shall be calculated only by the number of Hours actually provided. The difference between the Monetary Contribution and the Reduced Contribution shall be added to the balance of the Applicant's available grant funds. For avoidance of doubt, the amount that can be added to the Applicant's available grant funds is the amount of money that is subtracted out of the Monetary Contribution for the completion of Hours to calculate the Reduced Contribution. Proof of completion of Hours shall be provided to the Agency before release of grant funds. 3. Warranties of the Applicant. The Applicant warrants that the following information is true and correct: a. The Applicant is the owner of the Property; b. A single-family home is located on the Property; c. The Property is located in the Redevelopment Area; d. The Property is the primary residence and legal homestead of the Applicant or meets an alternative qualification under the Policy; e. The Applicant is current on their property taxes for the Property or a payment plan has been approved by the Director; f. The Applicant is current on all mortgage payments, if applicable; 2 g. The Property has no outstanding code enforcement or building code violations or the Applicant has made the Agency aware of such violations and the Agency has agreed to allow the Project to move forward as the renovations will remediate any violations; and h. The Property has not received a grant from the Agency in the preceding thirty-six (36) months prior to the Effective Date. III. AGENCY RESPONSIBILITIES 1. Grant Funding. The Agency shall reimburse the Applicant for the Project's eligible costs up to a base amount of twelve thousand one hundred twenty dollars and 00/100 cents ($12,120.00). Depending upon the number of Hours completed or a waiver of the community service option pursuant to the Policy, the Applicant may receive up to an additional one thousand five hundred fifteen dollars and 00/100 cents ($1,515.00) in grant funds for a total grant not to exceed thirteen thousand six hundred thirty-five dollars and 00/100 cents ($13,635.00) (the "Grant Funds"). The Grant Funds shall be payable within thirty (30) days of receipt of a fully completed reimbursement request after the issuance of a Finding of Project Completion by the Agency assuming the Applicant has also complied with Section II of this Agreement where applicable. 2. Upon agreement between the Agency and the Applicant, the Agency may provide the Grant Funds directly to any approved licensed contractor or vendor in lieu of providing the Grant Funds to the Applicant. Notwithstanding Paragraph 1 of this section, The Agency's director (the "Director") may allow earlier draw requests of the Grant Funds to approved licensed contractors or vendors in accordance with the Policy. However, the Grant Funds disbursed to a contractor or vendor shall not be disbursed more frequently than once every thirty (30) days. The Parties understand and agree that nothing in this Agreement creates any contractual relationship between the Agency and any contractor or vendor and the Agency shall not be liable for any monies owed to any contractor or vendor. The ability of the Agency to pay the contractor or vendor directly is only for the sake of convenience to the Applicant and the Applicant remains exclusively liable for any funds owed to the contractor or vendor. 3. If the Director determines that a reimbursement request does not meet the requirements of this Agreement or the Policy, then the Parties agree that the Agency shall not owe any monies to the Applicant for the requested reimbursement, the Applicant shall have no recourse against the Agency, and the Director's decision shall be final without any means of appeal. IV. APPLICANT DEFAULT 1. Failure to Timely Complete the Project. If the Applicant fails to obtain a Finding of Project Completion within one hundred eighty (180) days of the date of application approval, then the Parties agree that the Applicant shall be in default under this Agreement without notice or opportunity to cure the default. An extension to this timeframe may be granted by the Director for good cause if the Applicant submits a written request for such an extension before the expiration of the one hundred eighty (180) day period. 3 2. Other Events of Default. In addition to the foregoing event of default, the occurrence of any one or more of the following events after the Effective Date shall also constitute an event of default by the Applicant: a. The Applicant makes a general assignment for the benefit of its creditors, or admits in writing its inability to pay its debts as they become due or files a petition in bankruptcy, or is adjudicated a bankrupt or insolvent, or files a petition seeking any reorganization, arrangement, composition, readjustment, liquidation, dissolution or similar relief under any present or future statute, law or regulation or files an answer admitting, or fails reasonably to contest, the material allegations of a petition filed against it in any such proceeding, or seeks or consents to or acquiesce in the appointment of any trustee, receiver or liquidator of the Applicant or any material part of such entity's properties; b. Within sixty (60) days after the commencement of any proceeding by or against the Applicant seeking any reorganization, arrangement, composition, readjustment, liquidation, dissolution or similar relief under any present or future statute, law or regulation, such proceeding shall not have been dismissed or otherwise terminated, or if, within sixty (60) days after the appointment without the consent or acquiescence of the Applicant or any trustee, receiver or liquidator of any such entities or of any material part of any such entity's properties, such appointment shall not have been vacated; or c. A breach by the Applicant of any other term, condition, requirement, or warranty of this Agreement or the Policy. 3. Agency's Remedy Upon Certain Applicant Default. In the event of default and if the Applicant has failed to cure the default within the allotted time prescribed under Section IV, Paragraph 4 (if applicable), then the Parties agree that: a) this Agreement shall be null and void; b) that the Agency will have no further responsibility to the Applicant, including the responsibility to tender any remaining amounts of the Grant Funds to the Applicant; and c) that if the Agency has tendered any of the Grant Funds to the Applicant, the Agency shall be entitled to the return of all the Grant Funds plus default interest at a rate of ten percent (10%) starting from the date of default. The remedial provisions shall survive the termination of this Agreement. 4. Notice of Default and Opportunity to Cure. The Agency shall provide written notice of a default under Section IV, Paragraph 2 of this Agreement and provide the Applicant thirty (30) days from the date the notice is sent to cure such a default. This notice will be deemed received when sent by first class mail to the Applicant's notice address or when delivered to the Applicant if sent by a different means. V. MISCELLANEOUS 1. Notices. All notices, demands, requests for approvals, or other communications given by either party to another shall be in writing, and shall be sent to the office for each party indicated below and addressed as follows: 4 To the Applicant: Curlene Townsend 806 Engman Street Clearwater, FL 33755 To the Agency: Community Redevelopment Agency of the City of Clearwater P.O. Box 4748 Clearwater, Florida 33758 Attention: Executive Director with copies to: City of Clearwater P.O. Box 4748 Clearwater, Florida 33758 Attention: Clearwater City Attorney's Office 2. Unavoidable Delay. Any delay in performance of or inability to perform any obligation under this Agreement (other than an obligation to pay money) due to any event or condition described in this section as an event of "Unavoidable Delay" shall be excused in the manner provided in this section. 3. "Unavoidable Delay" means any of the following events or conditions or any combination thereof: acts of God, acts of the public enemy, riot, insurrection, war, pestilence, archaeological excavations required by law, unavailability of materials after timely ordering of same, building moratoria, epidemics, quarantine restrictions, freight embargoes, fire, lightning, hurricanes, earthquakes, tornadoes, floods, extremely abnormal and excessively inclement weather (as indicated by the records of the local weather bureau for a five year period preceding the Effective Date), strikes or labor disturbances, delays due to proceedings under Chapters 73 and 74, Florida Statutes, restoration in connection with any of the foregoing or any other cause beyond the reasonable control of the party performing the obligation in question, including, without limitation, such causes as may arise from the act of the other party to this Agreement, or acts of any governmental authority (except that acts of the Agency shall not constitute an Unavoidable Delay with respect to performance by the Agency). An application by any party hereto for an extension of time pursuant to this section must be in writing, must set forth in detail the reasons and causes of delay, and must be filed with the other party to this Agreement within thirty (30) days following the occurrence of the event or condition causing the Unavoidable Delay or thirty (30) days following the party becoming aware (or with the exercise of reasonable diligence should have become aware) of such occurrence. The party shall be entitled to an extension of time for an Unavoidable Delay only for the number of days of delay due solely to the occurrence of the event or condition causing such Unavoidable Delay and only to theextent that any such occurrence actually delays that party from proceeding with its rights, duties and obligations under this Agreement affected by such occurrence. In the event the party is the Applicant then the Director is authorized to grant an extension of time for an Unavoidable Delay for a period of up to six (6) months. 5 Any further requests for extensions of time from the Applicant under this section must be agreed to and approved by the Agency's Board of Trustees. 4. Indemnification. The Applicant agrees to assume all inherent risks of this Agreement and all liability therefore, and shall defend, indemnify, and hold harmless the Agency and the City of Clearwater, Florida, a Florida municipal corporation ("the City"), and the Agency's and the City's officers, agents, and employees from and against any and all claims of loss, liability and damages of whatever nature, to persons and property, including, without limiting the generality of the foregoing, death of any person and loss of the use of any property, except claims arising from the negligence of the Agency, the City, or the Agency's or the City's agents or employees. This includes, but is not limited to, matters arising out of or claimed to have been caused by or in any manner related to the Applicant's activities or those of any approved or unapproved invitee, contractor, subcontractor, or other person approved, authorized, or permitted by the Applicant whether or not based on negligence. Nothing herein shall be construed as consent by the Agency or the City to be sued by third parties, or as a waiver or modification of the provisions or limits of Section 768.28, Florida Statutes, or the Doctrine of Sovereign Immunity. 5. Assignability; Complete Agreement. This Agreement is non -assignable by either party and constitutes the entire Agreement between the Applicant and the Agency and all prior or contemporaneous oral and written agreements or representations of any nature with reference to the subject of this Agreement are canceled and superseded by the provisions of this Agreement. 6. Applicable Law and Construction. The laws of the State of Florida shall govern the validity, performance, and enforcement of this Agreement. This Agreement has been negotiated by the Agency and the Applicant, and the Agreement, including, without limitation, the exhibits, shall not be deemed to have been prepared by the Agency or the Applicant, but by all equally. 7. Severability. Should any section or part of this Agreement be rendered void, invalid, or unenforceable by any court of law, for any reason, such a determination shall not render void, invalid, or unenforceable any other section or part of this Agreement. 8. Amendments. This Agreement cannot be changed or revised except by written amendment signed by the Parties. 9. Jurisdiction and Venue. For purposes of any suit, action or other proceeding arising out of or relating to this Agreement, the Parties do acknowledge, consent, and agree that venue thereof is Pinellas County, Florida. Each party to this Agreement hereby submits to the jurisdiction of the State of Florida, Pinellas County and the courts thereof and to the jurisdiction of the United States District Court for the Middle District of Florida, for the purposes of any suit, action or other proceeding arising out of or relating to this Agreement and hereby agrees not to assert by 6 way of a motion as a defense or otherwise that such action is brought in an inconvenient forum or that the venue of such action is improper or that the subject matter thereof may not be enforced in or by such courts. If, at any time during the term of this Agreement, the Applicant is not a resident of the State of Florida or has no office, employee, agency, registered agent or general partner thereof available for service of process as a resident of the State of Florida, or if any permitted assignee thereof shall be a foreign corporation, partnership or other entity or shall have no officer, employee, agent, or general partner available for service of process in the State of Florida, the Applicant hereby designates the Secretary of State, State of Florida, its agent for the service of process in any court action between it and the Agency arising out of or relating to this Agreement and such service shall be made as provided by the laws of the State of Florida for service upon a nonresident; provided, however, that at the time of service on the Florida Secretary of State, a copy of such service shall be delivered to the Applicant at the address for notices as provided in Section V, Paragraph 1. 10. Termination. If not earlier terminated as provided in this Agreement, this Agreement shall expire and shall no longer be of any force and effect one hundred eighty (180) days from the anniversary of the date of application approval. IN WITNESS. WHEREOF, the Parties have caused this Agreement to be executed on the date and year first above written. (CRA SIGNATURE PAGE) Approved as to form: COMMUNITY REDEVELOPMENT AGENCY OF THE CITY OF CLEARWATER, FLORIDA, a public body corporate and politic of the State of Florida. By: Jesus Nino CRA Executiv�Dipe� qr� Date: (/ Attest: Matthew J. Mytych, Esq. Rosemarie Call CRA Attorney City Cler Date: Z/( IP 6- Dat-: 8 (APPLICANT SIGNATURE PAGE) APPLICANT: By ( Print name: LA..1 r( ✓► e -11),,un Sem_-Z/ Titled v j v . tit om/ Date: 3— 9 01002 C STATE OF FLORIDA ) COUNTY OF PINELLAS ) The foregoing instrument was acknowle ged before me by means' physical resenc or ❑ online notarization, this 9 day of , 2026 by(tli °is/are personally known to me or ho has/have produced a driver's license as identification. (NOTARIAL SEAL) so ,,,_ *We L. Shire}., Comm.: HH WW2 ff€ Expires: Jan. 211, 2029 K� '"Notary PubWc • State of Honda 9 Notary Public, State of F orida `— Name of Notary: �. ". t- Ls S 11( — My Commission Expires: My Commission No.: i-1 if (LI go 5� �— EXHIBIT "A" LEGAL DESCRIPTION The East 55 feet of Lots 7 and 8, Block 1, C.E. JACKSONS SUBDIVISION, according to map or plat thereof as recorded in Plat Book 2, Page 96 of the Public Records of Hillsborough County, Florida, which Pinellas County was formerly a part. 10 EXHIBIT "B" RESIDENTIAL EXTERIOR IMPROVEMENT GRANT PROGRAM POLICY 11 RESIDENTIAL EXTERIOR IMPROVEMENT GRANT PROGRAM APPLICATION FORM City of Clearwater Community Redevelopment Agency North Greenwood Community Redevelopment Area TABLE OF CONTENTS SECTION 1 — PROGRAM GOAL 1 SECTION 2 — PURPOSE AND INTENT 1 SECTION 3 — AVAILABLE ASSISTANCE AND PROGRAM ELIGIBILITY 2 SECTION 4 — ELIGIBLE RESIDENTIAL IMPROVEMENTS 4 SECTION 5 — PROGRAM REQUIREMENTS AND APPLICATION PROCESS 5 SECTION 6 — DISBURSEMENT POLICY AND PROCEDURE 6 SECTION 7 — GRANT EXPIRATION 7 SECTION 8 — COMPLIANCE WITH THE CITY OF CLEARWATER ETHICS CODE 7 SECTION 9 — APPLICATION 8 SECTION 10 — ELIGIBLE CRA AREA MAP 11 Residential Exterior Improvement Grant Program Approved by the CRA Trustees July 15, 2024 E Case Number: RESIDENTIAL EXTERIOR IMPROVEMENT GRANT PROGRAM The Program provides a matching grant of up to $20,000. SECTION 1 — PROGRAM GOAL The City of Clearwater (City) Community Redevelopment Agency (CRA) Residential Exterior Improvement Grant Program (Program) is designed to increase access to redevelopment funding for residential improvements to homesteaded single-family homes in the North Greenwood Community Redevelopment Area (NGCRA). The purpose of the Program is to rehabilitate single family homes, improve property conditions, aesthetics, reduce housing cost burden, and aid in the elimination of slum and blight. The focus of this Program is directed to the exterior improvement of residential properties to enhance neighborhood aesthetics and pride. SECTION 2 — PURPOSE AND INTENT The purpose of the Program is to support the implementation of the adopted Community Redevelopment Area Plan (Plan) for the North Greenwood Community Redevelopment Area in accordance with the Florida Community Redevelopment Act of 1969. Sections 163.330, et seq., Florida Statutes, by: 1) Carrying out plans for a program of voluntary or compulsory repair and rehabilitation of buildings or other improvements in accordance with the community redevelopment plan (Sections 163.370(2)(c)(5), Florida Statutes). 2) Reducing the percent of households that are housing cost burdened (Plan Section 3.2, Goals and Objectives, Goal 4 Housing Affordability, Objectives, page 94). 3) Prioritizing keeping existing residents in their homes through funding for addressing property maintenance and building code issues and reducing visual blight (Plan Section 3.3, Redevelopment Policies, Housing, page 95). 4) Developing grant programs to improve the exterior and interior of blighted properties (Plan Section 4.5, Plan Implementation, Table 15, Goal 1 Policy Implementation: Public Safety, page 134). 5) Developing programs to encourage neighborhood pride in yard and home appearance (Plan Section 4.5, Plan Implementation, Table 15, Goal 1 Policy Implementation: Public Safety, page 136). 6) Providing emergency assistance funds for low-income residents for life safety home repairs and renovations to accommodate physical disabilities. (Plan Section 4.5, Plan Implementation, Table 15, Goal 4 Policy Implementation: Housing Affordability, page 140). 7) Creating a grant program to reduce blight through the repair and preservation of historic homes (Plan Section 4.5, Plan Implementation, Table 15, Goal 4 Policy Implementation: Housing Affordability, page 142). 8) Creating value for the citizens of Clearwater and improving the North Greenwood CRA by (themes stressed throughout the Plan): a) Promoting a resident and neighborhood friendly atmosphere; 1 b) Promoting economic development and neighborhood revitalization; c) Incentivizing property owners to enhance and sustain the, values of their property; d) Creatinga more inviting and visually appealing atmosphere; and e) Instilling a greater sense of place and civic identity. It is not the intent of the CRA to engage in any rehabilitation activity that requires vacating property or displacing any residents from property. Moreover, this Program does not assist in temporary relocation cost or the development of new construction projects. Rather, it is to rehabilitate existing single-family structures. SECTION 3 — AVAILABLE ASSISTANCE AND PROGRAM ELIGIBILITY The Program provides a matching grant, as specified below, of up to $20,000 to assist applicants with exterior home repairs. Program assistance is based on a sliding scale and adjusted for family size and income limits, which are subject to change from time to time. Applicants with Household incomes that exceed 120% Area Median Income do not qualify for this Program. Applicant will match the grant amount by the percentages listed below (must provide proof of matching funds prior to project work commencing): Area Median Income (AMI) % ' Applicant Contribution/Match 0 — 30% 5%* 31%-50% 10%* 51% — 80% 15%** 81% —120% 20%** ,121% — plus Not eligible for grant. *Match may be waived at the rate of one hour of community service per $150 of approved grant amount and will be added back into the total grant amount not to exceed $20,000. **Up to 50% of Applicant's match may be waived at the rate of one hour of community service per $150 of approved grant amount and will be added back into the total grant amount not to exceed $20,000. (Community Service must be performed by Applicant, or anyone over 18 years of age legally residing in the home, within the NGCRA boundary and through a tax- exempt not-for-profit organization recognized by the CRA or City of Clearwater. Community service must be performed without pay or compensation from the not-for- profit organization, and service must be performed in full hour increments rounding up to the nearest whole hour. Scope of community service must be pre -approved, by the CRA Director, prior to commencement. In addition, said community service must be performed prior to release of grant funds.) The CRA Director may waive, or reduce, on a case-by-case basis, the community service provision for certain individuals with disabilities, including age related disabilities, or other verifiable hardships, that prevent the Applicant, and anyone over 18 years of age legally residing in the home, from performing community service. In the event the waiver is granted, then the Applicant Contribution/Match will be set to zero percent. The grant is a reimbursement grant, unless otherwise approved by the CRA Director to pay an approved licensed contractor directly, no more than one payment within a 30 -day period. The CRA Director may require in all grant applications that licensed contractors 2 be paid directly, eliminating the need for homeowners to pay contractors, and then requesting reimbursement from the CRA. The chart below is data provided by the Florida Housing Finance Corporation (FHFC) which is based upon figures provided by the United States Department of Housing and Urban Development (HUD) and are subject to change. Updated charts. by FHFC will supersede any income limit chart provided within this document. When updates are made available by FHFC, the chart below will be updated. County (Metro) Percentage Category Income Limit by Number of Persona in Household 1 2 3 4 5 6 7 8 Pinellas County 30% 21,050 25,050 28,200 32,190 37,650 43,190 48,650 54,150 ITarnpaNSti?elarelaurg- 559 36,5500 41,7011 46,950 52,150 56,350 60,550 84,700 684150 Clearwater MSA) 80% 58,450 66,800 75,1150 83,450 90,150 96,860 103,500 110200 Median: '+:,400 123% 87,8600 100,080 112,680 125,1 71, 135240 14200 1155,260 165;240 140% 102,200 116,780 131,400 146,020 157,7811 169,400 181,160 192,7 r� Eligibility Criteria To be eligible for the Program, the project/property must meet all the following qualifications: • Applicant must be the owner of the subject property. * • The subject property must be a single-family home. • Property must be located within the North Greenwood Community Redevelopment Area. • The single-family home must be the primary residence and legal homestead of the Applicant. In addition, the following may qualify for the Program. • Owners of property that have applied to Pinellas County for homestead exemption consideration may be eligible for this Program. • Applicants that reside at the property, control said property other than through outright ownership, and are authorized to approve the repairs and other work that are the subject of this program, may provide alternative documents to substantiate that they have such control and authority regarding the property. This documentation may include probate court documents, wills, heirship affidavit, letters of administration, or other legal documentation. After review of the documents, the residing applicant(s) may qualify for the Program, provided the applicant(s) wishing to apply for the Program reside at the property as their primary residence. If such control or authority is disputed by another party or parties, the application may be denied until such time as the Applicant resolves such disputes. • Must demonstrate property taxes are current or a satisfactory payment plan is approved by the CRA Director. • Must be current on mortgage payments (if applicable). • Must be in good standing •with the city (no outstanding code enforcement or building code violations). This requirement may be waived by the CRA Director if the work proposed under this application will remediate the code violations. • If combined with a Home Rehabilitation Loan from the Economic Development and Housing Department, other requirements may vary. *The owner of the Property (Owner) shall be the Applicant. Owner means a holder of any legal or equitable estate in the premises, whether alone or jointly with others and 3 whether in possession or not shall include all individuals, associations, partnerships, corporations, limited liability companies and others who have interest in a structure and any who are in possession or control thereof as agent of the owner, as executor, administrator, trustee, or guardian of the estate of the owner. No Owner shall receive more than $20,000 in total CRA grant value across all CRA grant programs within a 36 - month rolling year. For the purposes of this application, the total CRA grant value that an Owner has received over such period shall be the combined value, in the 36 month period immediately preceding the submission of an application for this program, of: (1) the amount of CRA grant funds that the applicant has received; (2) the amount of CRA grant funds that any holder of legal title in the subject property other than the applicant has received; and (3) if a business entity holds legal title in the subject property, the total amount of CRA grant funds received by any directors, members, partners, shareholders, any others with an ownership interest in such entity, and any others able to exert managerial control over or direct the affairs of said entity. Previous Participation — Each property may not receive a grant any more than every thirty-six months. The following are ineligible for Program assistance: • Work or improvements that are completed prior to an application being approved. • Any unpermitted work or improvements performed on the property that required a permit and inspections. • Any work or improvements on the property that fail required inspections. • Multi -family properties. • Properties that do not qualify for homestead exemption. • New construction or improvements on vacant land. Project Implementation Projects are to be coordinated, managed, and implemented by the Applicant with close interaction with Community Redevelopment Agency Department staff and the appropriate City departments. Applicant is responsible for obtaining/arranging any permits required by the city. SECTION 4 — ELIGIBLE RESIDENTIAL IMPROVEMENTS One or more of the following improvements maybe eligible for Program assistance: 1) Exterior repairs (walls, foundation, piers, siding, etc.); 2) Exterior painting; 3) Exterior windows and doors; 4) Roof repairs or replacement, including facia board, soffits, and gutters; 5) Window or door awnings and shutters (including hurricane shutters; replacement or repair); 6) Exterior weatherization improvements; 7) The installation, repair, or renovation of porches; 8) The installation of decorative lighting; 9) Decorative fencing; 10) Driveway, pedestrian walkways/pathways, and sidewalk improvements; 11) American with Disabilities Act (ADA) accessibility improvements; 4 12) The installation of landscaping and irrigation systems, not to exceed twenty percent (20%) of the total grant amount; 13) Tree trimming or removal (requires city approval, and city may require a licensed arborist to confirm tree removal is necessary); 14) Heating, ventilation, and air conditioning (HVAC) systems; 15) Certain interior repairs: a. Interior deterioration/damage directly resulting from an exterior defect or damage, may qualify for grant funding to repair said deterioration/damage. Such interior repairs may include, but are not limited to, load bearing walls, drywall, insulation, and wood repair. However, grant funds must first be used for improvements or repairs to fully remedy the external defect or damage that resulted in such interior deterioration/damage prior to any use of grant funds on interior repairs. b. Interior deterioration/damage that is verified by the city as a life safety issue to home inhabitants. c. ADA accessibility improvements. 16) Home fumigation (including tenting if necessary) for termites; and 17) Other improvements may be submitted for consideration but must demonstrate that the improvement meets the intent of this grant program. The following improvements are not eligible for Program assistance: 1) Repairs to unsafe or substandard structures that cannot be made safe for habitation with Program funds. 2) Room additions, garage conversions, repairs to structures separate from the living units (detached garage, shed, etc.), furnishings, and pools. 3) Repairs covered by insurance. 4) Non -permanent improvements. 5) Enclosing a front porch. 6) Installation of window or door security bars. 7) General interior home improvements and repairs. SECTION 5 — PROGRAM REQUIREMENTS AND APPLICATION PROCESS Program Requirements • All statements and representations made in the application must be correct in all material respects when made. Any applicant requesting grant funding from this program will have their income verified by City staff and must supply the items listed below, and, if requested, any other income or employment documents that are not listed below: • If applicable, self-employed year to date profit and Toss statements. • All pages of last two year's tax returns, with all schedules and W-2s/1099(s). • Most recent and consecutive last two months of bank statements (with bank name and account number) (ALL PAGES, even if blank) for all household members with accounts. • If combined with a Home Rehabilitation Loan from the Economic Development and Housing Department, additional information may be required. Applicants that do not wish to have their income verified will automatically be disqualified from Program participation. 5 • • Color digital photographs of the existing structure exterior, showing all sides of the building, must be provided with application. • An estimated detailed budget must be provided on the attached project budget form (Attachment A). • Work required to be performed by licensed contractors. Applicant must provide, as attachments, three quotes from contractors and copies of their licenses. Quotes to include complete description of materials to be used). o If work is performed by non -licensed workers, then only materials purchased will be eligible for grant funds, unless the work performed was required to be performed by a licensed individual per City codes. • Portions of the project costs not funded by the requested grant must be provided by Owner funding. Owner funding may consist of bank loans, lines of credit, a Home Rehabilitation Loan from the city's Economic Development and Housing Department, and owned assets (Owner Equity), etc. • Owner must demonstrate their source of the Owner Funding and their ability to meet the financial obligations of the Program prior to Program approval. • Proceeds from other City -managed financial assistance programs may be used as Owner Equity to satisfy the Owner Funding requirements of this Program and may be used to assist with funding of remaining portion of larger improvement project. Grant funds cannot be used as Owner Equity to satisfy the Owner Funding requirements of other City -managed financial assistance programs. Grant Application Process • Submittal of an application does not guarantee a grant award. • Grant preference will be given to Applicants at or below 80% AMI, applicants 65 years of age and above, and the disabled. • Completed applications that meet all the Program requirements will be reviewed by the CRA Director. • .The CRA Director will approve or deny applications based on the criteria set forth in this document. • Incomplete applications will not be considered submitted until all required documentation has been submitted to Community Redevelopment Agency Department staff. • All construction/design contracts will be between the Applicant and the contractor/design professional. SECTION 6 — DISBURSEMENT POLICY AND PROCEDURE Grant funds will, unless otherwise approved by the CRA Director to allow initial project deposits or other necessary draws, up to fifty percent of the grant amount, to be paid directly to a City/CRA approved licensed contractor, be disbursed upon a "Finding of Project Completion" by CRA Director. A "Finding of Project Completion" will be granted when the following criteria are met: 1) Applicant must demonstrate their ability to meet the financial match/obligations of the Program and any required community service has been completed by qualifying applicants. 6 2) Requests for disbursement of project costs will be viewed as a single, completed package, unless prior disbursement of funds arrangements have been made to pay licensed contractors directly (no more than one payment within a 30 -day period). Costs not included in the approved application budget will not be considered for disbursement. 3) Required documentation for disbursement of project costs must include: a. Copies of cancelled checks, certified checks or money orders of project costs, or credit card statements of project cost; b. Detailed invoices and paid receipts signed, dated, and marked "paid in full;" c. Name, address, telephone number of design professional(s), general contractor, etc.; and d. Photos of the project (before and after photos). 4) The Applicant must have obtained all necessary/required permits (e.g. zoning and building), passed all required inspections, and prior to final disbursement of funds received (if relevant) notice, in the form of a Certificate of Occupancy or Certificate of Completion for the project demonstrating the legal occupancy of the project area. Any work performed without a permit that required a permit will not be eligible for grant funding. 5) The CRA disburses funds to grant recipients within 30 days of fully completed reimbursement request. SECTION 7 — GRANT EXPIRATION Applicants must receive a "Finding of Project Completion" within 180 calendar days from the date of application approval. After the said 180 days, the grant will expire. An extension for the grant funds may be granted by the CRA Director for a good cause. It is the responsibility of the Applicant to request, in writing, from the CRA Director an extension of the grant approval before the expiration date. SECTION 8 — COMPLIANCE WITH THE CITY OF CLEARWATER ETHICS CODE The applicant will comply with all applicable City rules and regulations including the City's Ethics Codes. Moreover, each applicant to the Program acknowledges and understands that the City's Ethics Code prohibit City employees from receiving any benefit, direct or indirect; from any contract or obligation entered with the City. 7 SECTION 9 — APPLICATION 1) Applicant (Property Owner) Full Legal Name(s): LAY Q it c 5 -rC9l t)ils PI/ (J` Mailing Address: e0(.0 o,c, ry a, if) s---1 y• e e7 City/State/Zipl,_ PI I7 :Cl e a r l mo'►' 3 3 '75-s Phone Number: 7 Z v1 -Y7 kr E-mail Addres 2) Subject Property Address commonly known as: r.l ot c,Kso,-, 5 u 1. C E 5 %b Parcel Identification Number(s): /0-dc'-1Lf35eic - ©Jl --001 3) Project description, scope of work to be performed, sketch plans and specifications detailing the scope of work (provide attachment(s) if needed). (Applicant understands that depending on the project, certain city departments may require additional documentation, plans, etc. to properly review and approve Rt,I the proposed project described in this application.) Ili l �l C i m s •Y' r., d Pc5,-k-r c ri J v.TC l i t 9 4) Financial and Other Disclosures Annual Household Income: .14 OD (Income examples (not limited to the following): employment or self-employment income, Social �Security, Pension, Disability, etc.) Household Size: a c,„1,1_, -,:i. ate #5 a? ctn !- . '5-6Y"`. Is the subject property current with property tax payments, mortgage payments (if applicable), fees, and in compliance with City codes and regulations? (must provide copies �o rope tax payment and -mortgage payment statements) Yes L14 No , If no, please explain: Have you received a loan or grant assistance from a city -managed financial assisla_nge program for a project at the subject property? Yes V No f If yes, please specify the program(s), dates received, and the loan/grant amount(s) below or provide attachment(s). Program Name: CI o ul GL_ f o I— ( ' Date Received: Amount Received $ Program Name: Date Received: Amount Received $ VS !6-Ilab--- 5) Amount of Grant Requested under this program: $ O O Are you requesting direct payment of approved grant funds to an authorized contractof ? YesIt No 0 If yes, please specify the contractor's name: Z(e c -f r. ic- J -yr �du'A-r0S e—O•n5tvut• ,' a� wi ,i e�Q WIC - Note: This option must be approved by the CRA Director. 9 Attachment A - Project Budget Form (Attach contractor/vendor estimates/quotes for consistency verification of items listed below. Contractor/vendor estimates/quotes improvement item descriptions and cost will supersede if improvement item descriptions and cost are listed different below. If more project budget form Tines are need, Applicant may duplicate budget template below on separate sheet. If new Project Budget Form is created, write "See Attached" in Line No. 1 below. For Applicant:Use For; staff use:only Linet ' • Item . Improvemeit(s) Item Description . (Including constructiottli atenals, labor, •;permitting, oth'erfees ;;etc:) . ,, 4. lmprovement(s} R Cost Amount " Line Item Eligible for grant Consideration . '. :Yes/No -' Cost Amount -+ `: Eligible for ,Grant., 1ii c�L U $ $ 2 �Cl7tr i C.—n r► , i Fa- hei $ $ 3 d+ o' • $ $ 4 /1� L -t9-/1 a 'lp --e. 1 ' 1 it -L.$ $ 5 ( $ $ 6 $ $ 7 $ $ 8 y'li3O $ $�G 6q 9 r' : - • n I► `, e 4 $ ,•) �� $ 10 n Q i�, ft f t C II f r-1'at $ t• $ 11 -t-Y�e ` ' 4,, ./4 g.DO $ 1 $ :-- 14 6 (J 6 3 . $ $ — 15 ^ ,31 "►r ' CuL $ 3,16o $ ...-- 16 V C $ n i l!V $ 17 $ $ • Total Improvements) Cost Amount . , Total Cost Amount Eligible for Grant Consideration ' _ _.✓ J . -„ u •;Line=No. , . ,, :: ... , , , s-, _.,5•'..7.,,/,;,",:,,• , � � " .; µ, for. Staff' Use Only .' i..t. 1,Total' Cost` Amount` Eligible' for Grant, Consideration (from'AttachmentA above and/orfromw attached contractor estimates/quotes _ -, $ 2 _ Amount of Grant Requestedbunder•this=program (Section 9 question 5 of Application): $ { 51. r' 3 Enter the amount with the lower monetary value fromseither Line No 1° Line.No 2 4sSection-3 Enter required Applicant Contnbution/Match (either•5%,•10% .:15% r,"20° contnbution/match ;;see ofGrant;Program),. ;t s $ �jJ,O3Q•-; 5 Subtract Lir a No 4; from Line No 3 and enter amount. ' , n 6 Enter value of eligible communityservice hours for contribution/match waiver if applicable (See Section 3 of Grant Program for value 01 service hour) il: • Number ofservice.hours•approved;t y CRA;Qirector..:-. I, 7 ` Add No. 6 to amount in Line No5 and enter amount ' '' 8 Enter amount froimLine No 7 This is -eligible,,4rant award amount to enter in approval letter ,,$ , .{ 3► �;3 t + 10 U Form (Rev. March 2024) Department of the Treasury Intemal Revenue Service Request for Taxpayer Identification Number and Certification Go to wwwirs.gov/FormW9 for instructions and the latest information. Give form to the requester. Do not send to the IRS. Before you begin. For guidance 1' Name. of entity/individual. on line 2.) (titYsname related to the purpose of Form W-9, see P.urpose:pf Form, below. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded �.1 A •�ti .,n 5 2 Business name/disregarded entity name, If different from above. 3a Check the appropriate box for federal tax classification of the entity/iindividual whose name is entered on line 1. Check only one of the following seven boxes. individuaVsole proprietor ❑ C corporation ❑ S corporation ❑ Partnership 0 Trust/estate ❑ LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) . . . . Note: Check the "LLC" box above and, In the entry space, enter the appropriate code (C, S, or P) forthe;tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the -appropriate box for the tax classification of its owner. ❑ Other (see instructions) 3b If on line 3a you checked "Partnership" or "Trust/estate." or checked "LLC" and entered "P" as its tax classification, and you are providing this form to a partnership, trust, or estate In which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries. See instructions 5 Address (number, street, and apt. or suite no.). See instructions. 0 CP g"n C .rvt c <4 6 City'state, and ZIP code ten ✓ Lir .4,f Ft 3 '( 5 7 List account number(s) here (optional) Part 1 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Exemption from Foreign Account Tax Compliance Act (FATCA) reporting code (if any) (Applies to accounts maintained outside the United States.) Requester's name and address (optional) Taxpayer identification Number (TIN) EnteryourllN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals,- this Is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part 1, later. For other entities, it is your employer identification number (EIN). tf you do not have a number, see How to get a TIN, later. Note: If the account is in more than one name, see the instructions for fine 1. See also What Name and Number To Give the Requester•for guidelines on whose number to enter. Part 11 Soda! security number or Employer identiffoation number Certification . . Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because (a) 1 am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends. Cr (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and • 4. The FATCA code(s) entered on this form (if any) indicating that 1 am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For realestate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments other than interest and dividends, you are not: required to sign the certification, but you mustdeyour correct TIN. See the instructions for Part ll, later. Sign signature of Here us. person .. General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as Ieglsiatjod enacted after they were published, go to www.irs.gov/FormW9. What's New Line 3a has been modified to`ctarify how a disregarded entity completes this line. An.LLCathat is a disregarded entity should ctieck the appropriate box for the tax classification of its owner:'Otherwise,'it • should check the "LLC" box and enter its appropriate tax classification: • Date 1 — 7 New line 3b has been added to this form. A flow-through entity is required to tompletethie line to ind(cate'thatit has direct or indirept foreign partners„owners, or beneficiaries. when it provides the°Forrn W-9 . to another flow-through entity In vuiiich it has'an ownership interest. This change Is intended to7provide a flow_through entity,with inf o niation regarding the status of its indirect foreign partners, owners, .or beneficiaries so that it can.satisfy any applicable reporting requirements For example, a partnership that has any indirect foreign partners may •weciCiired to complete Schedules K.2.- and -k-g. Seethe Partnership Instr'uctionafor`Schedules K-2 and K-3Vorm 1065). . Purpose of Form An individual or entity(FormW-9 requester) who is required to file an information return with the iRS is giving you this form because they Cat. No:10231X Form W-9 (Rev. 3-2024) PLEASE NOTE: For multiple signers: This Application may be executed in one or more counterparts, each of which when executed and delivered, shall be an original, but all such counterparts shall constitute one and the same instrument. I ACKNOWLEDGE. THAT I HAVE RECEIVED AND UNDERSTAND THE GRANT GUIDELINES HEREIN ABOVE STATED. IN ADDITION, BY EXECUTING THIS APPLICATION, I ACKNOWLEDGE THAT I AM LAWFULLY AUTHORIZED TO EXECUTE THIS APPLICATION AND THAT ALL INFORMATION AND STATEMENTS CONTAINED HEREIN AND ON ANY ATTACHEMENTS ARE TRUE, CORRECT, AND COMPLETE. r e fAe vt_A_Pefrl Applicant Signature Printed Name Date STATE OF 5.LO DA COUNTY OF PINEL.LAS before me this 19 day of ivcvrrioq. 20 24 , who [. ] is personally known to me or [ has The foregoing instrument was acknowledged by CiQi ENE -rotor\i< o produced identification. Type of identification produced: FL to My commission expires: (Notary Seal) 5 Not. Public Signature Notary Public Print Name .ot i"r:Z''•. Julia C. Sakes NI. Comm.: HH 601100 , , Expires: Oct 7, 2028 °�,5• Notary Public • State of Florida Mail or hand deliver completed application form to: Community Redevelopment Agency City of Clearwater / 600 Cleveland Street, Suite 600 / Clearwater, FL 33755 For question call the Community Redevelopment Department at 727-562-4039 11 Residential Exterior Improvement Grant Program Due Diligence Check Applicant: GUKLENE SEND Property Address: Q6O(0 EN6 1'YlP- 3j c5Z CRA: NG Case Number: Requirement: 1. Located in CRA Boundary 2. Single -Family Residential Property 3. Property Owner/Applicant is Property Owner 4. Primary Residence/Legal Homestead 5. Detailed Project Budget/Project Viability 6. Photographs Line Item Quotes from Licensed Contractors 8. Requesting Direct Contractor Pay 9 Applicant Qualified for Grant Preference 10. Scope of Work Eligible for Grant Award 11. Applicant Appears to Meet Program Financial Obligations 12. Property Tax Current 13. Code Violations 14. Household A��jj I Under 80% le fiatCiwn is Match Volunteer Hours or 16. W9 17. Purchace Order 18. Additional Information Total Project Cost Eligible for Grant Consideration Owner Match Amount .4, /rant Amount Recommended by Staff Yes ago Yes✓N o_ Yes vljlo Yes ✓No Yes No Yes�o Yes No YesAo Yes No Yes ✓I 10 Yea) Yes_✓No Yes_ Nct../ Yes_ No Yes‘.'1e Yes_ No Yes No Comments: SU() �v �fl Ar 31 kl_SO ^1E-t-r1E - 51mS CtALI EST. 5o homestead (t) -PA-NeL, / (4) W' ioi,J/CSS 1 Cps) cY `5 h5V? -fps • . r v 5 , ISv 630- — / c26 L,(,35 w:_ Ye�No Yei/No_ Date: I ( n��O Date] 3s/Z dip w2R� PPA' uSova GSD— 6471,41 \;nu- zfyolI 2/13/25, 11:59 AM Mike Twitty, MAI, CFA Pinellas County Property Appraiser Parcel Summary (as of 13 -Feb -2025) Parcel Number 10-29-15-43596-001-0071 • Owner Name TOWNSEND,CURLER! NETTIE B SIMS CLAY EST • Property Use 0110 Single Family Home • Site Address 806 ENGMAN ST CLEARWATER, FL 33755 • Mailing Address 806 ENGMAN ST CLEARWATER, FL 33755-3213 • Legal Description JACKSON'S, C. E. SUB BLK 1, E 55FT OF LOTS 7 AND 8 • Current Tax District CLEARWATER jam() • Year Built 1951 Living SF Gross SF Living Units Buildings 1,018 1,018 1 1 Parcel Map Exemptions Year Homestead Use % Status Property Details 1 Pinellas County Property Popraiser ' 150 •-12 Property Exemptions & Classifications 2025 Yes 50% 2024 Yes 50% Miscellaneous Parcel Info No Property Exemptions or Classifications found. Please note that Ownership Exemptions (Homestead, Senior, Widow/Widower, Veterans, First Responder, etc... will not display here). Last Recorded Sales Comparison Census Tract Evacuation Zone Flood Zone Deed Elevation Certificate Zoning Plat Bk/Pg 15467/0951 $203,500 262.00 E Current FEMA Maps Check for EC Zoning Map H2/96 2024 Final Values Year Just/Market Value Assessed Value/SOH Cap County Taxable Value School Taxable Value Municipal Taxable Value 2024 $171,600 $55,451 $37,296 $85,800 $37,296 https://www.pcpao.gov/property-details?s=152910435960010071 &input=806+Engman&search_option=address&start=0&length=10&order_column=5... 1/4 / 2/13/25, 11:59 AM Value History Year Homestead Exemption Property Details I Pinellas County Property Appraiser - 1- • • ' 0- • " • ' I Just/Market Value Assessed Value/SOH County Taxable School Taxable Municipal Taxable Cap Value Value Value 2023 Y $145,171 2022 Y $138,090 2021 Y $80,310 2020 Y $77,292 2019 Y $69,290 $51,531 $33,905 $72,585 $33,905 $47,936 $30,823 $69,045 $30,823 $44,636 $28,021 $40,155 $28,021 $41,860 $25,474 $38,646 $25,474 $39,176 $23,158 $34,645 $23,158 24 Tax Information ^ 1111, Do not rely on current taxes as an estimate following a change in ownership. A significant change in taxable value may occur after a transfer due to a loss of exemptions, reset of the Save Our Homes or 10% Cap, and/or market conditions. Please use our Tax Estimator to estimate taxes under new ownership. Tax Bill 2024 Millage Rate Tax District View 2024 Tax Bil( 18.9481 (CW) t:Salesiiistory Sale Date Price Qualified / Unqualified Vacant / Improved Grantor Grantee Book/Page 08 -Nov -2006 23 -Oct -2003 22 -Aug -1996 12 -Jul -1996 08 -Jul -1996 $100 $100 $100 $0 $600 u u LJ u FAISON ETHEL LEE SIMS ETHEL CLAY THEODIS G CLAY THEODIS G CLAY THEODIS G SIMS, NETTIE B 15467/0951 SIMS, NETTIE B 13163/0796 SIMS, NETTIE B. 09441/1712 SIMS, NETTIE B. 09402/0231 SIMS, NETTIE B. 09396/0857 i2024 Land Information • Land Area: a: 5,536 sf 0.12 acres Property Use Land Dimensions Frontage and/or View: None Seawall: No Unit Value Units Method Total Adjustments Adjusted Value Single Family 55x100 $1,975 55.00 FF 1.0600 $115,142 2024 Buildingl..Structural Elements and.SubAriainfOrmation Structural Elements - -` • ' ' " Foundation:Continuous Footing'Poured Floor System: Wood ' Exterior VVells: 11 Frame Stucco- Unit Stories: • 1 Living Units 9 1, . • , Roof Frame: - Gable Or Hip -‘ " • • , - Roof Cover. „ Shingle Composition ' ' , . "`" • " •• Sub Area . Area SF Gross Area SF, ,• Base (BAS) '. 576 , 576 Base Sernt-finiihed (BSF) , 442 " ° 442, Total Arfia'SF: 1648 1 018 0011ding Type : ' Single Family , • „ Fair • 6 Floor Finish: Carpet/ Vinyl/Asphalt f Interior Finish: DrywalUPladter heating : Central Duct Cooling: - COoliog (Cential) , • . Fixtures: ' - 3 ' .,..r.,,,i•• :.., ,,,,,,,,, „, , . ,,,,, :.,• .....,.., ,, , ., °,°;kl.:- https://www.pcpao.gov/property-details?s=152910435960010071&input=806+Engman&search_option=address&start=0&Iength=10&order_column=5... / 2/13/25, 11:59 AM 14 Description 13. 14 Property Details 1 Pinellas County Property Appraiser 2024 Extra Features -�a , , B SF 322 27 24 OAS 24 24 576 22 BSF 120 20 Value/Unit Units 10 Total Value as New Depreciated Value Year PATIO/DECK $14.00 SHED $22.00 SOLAR $2.50 680.0 $9,520 $3,808 1955 108.0 $2,376 $1,188 2005 3,300.0 $8,250 $8,250 2022 /permit Data. Permit information is received from the County and Cities. This data may be incomplete and may exclude permits that do not result in field reviews (for example for water heater replacement permits). We are required to list all improvements, which may include unpermitted construction. Any questions regarding permits, or the status of non -permitted improvements, should be directed to the permitting Jurisdiction in which the structure is located. Permit Number Description Issue Date Estimated Value BCP2024-051014 WINDOWS/DOORS BCP2022-120179 SOLAR PANELS BCP2022-100735 FENCE BCP2021-110172 HEAT/AIR BCP2020-120297 ROOF BCP2019-030848A FENCE BCP2019-030848 FENCE 06/25/2024 $13,578 12/19/2022 $50,000 10/24/2022 $1,200 02/17/2022 $11,777 12/10/2020 $15,000 06/10/2019 $400 03/26/2019 $1,400 https://www.pcpao.gov/property-details?s=152910435960010071 &input=806+Engman&search option=address&start=0&length=10&order_column=5... 3/4 2/13/25, 11:59 AM Permit Number Description Property Details I Pinellas County Property Appraiser Date Estimated Value BCP2014-03156 HEAT/AIR BCP2008-07247 MISCELLANEOUS BCP2004-06526 ADDITION/REMODEURENOVATION 03/10/2014 08/12/2008 07/19/2004 $6,500 $0 $2,500 https://www.pcpao.gov/property-details?s=152910435960010071&input=806+Engman&search_option=address&start=0&length=10&order column=5... 4/4 I#: 2006410135 BK: -5467 PG: 951, 11/08/2006 at 10:56 AM,-- CORDING 1 PAGES $10.00 D DOC ST •LLECTION $0.70 KEN BURKE, CLERK OF( )RT PINELLAS COUNTY, FL BY DEP • JLERK: CLKDU13 , Return to: Name: Address: STATEWIDE TITLE SERVICES, LLC 4424 * Kennedy bd., Ste. B Tampa, FL 33609 This Instrument Prepared by: CHRIS M RODRIGUEZ Statewide Title Services, LLC 4424 W. Kennedy Blvd, Ste. B Tampa, Florida 33609 as a necessary incident to the fulfillment of conditions contained in a itle insurance commitment issued by it. ` let t,a,; t51455/6Aowtool i Property Ap raisers Parcel I.D. (Folio) Number(s): Grantee(s) S.S.#(s): File No:20060087 QUITCLAIM DEED (INDIVmUAL) THIS INDENTURE, Made thi 18TH day of OCTOBER, 2006, by and between ETHEL LEE FAISON F/K/A ETHEL SIMS, a married womaK hereinafter collectively referred to as "Seller", and 4. $06 F r49 rnAty Si- . CJI_En tu4.)Aw r)Fitt 155 .y and NETTIE�B SIMS and CURLENE TOWNSEND hereinafter collectively referred to as "Buyer", 4' SO to L N g nr% A N St . C-L>=A rttu q -}-F R) FL. 3 3165 WITNESSETH: That Seller, for and in consideration of the sum of $10.00 Dollars and other valuable considerations, lawful money of the United States of America, to Seller in hand paid by the Buyer, the receipt whereof is hereby acknowledged, has remised, released and quitclaimed to the Buyer, Buyer's heirs and assigns forever, all the rights, title, interest and claim of the Seller in and to the following described land in Pinellas County, Florida, to wit: The East 55 feet of Lots 7 and 8, Block 1, C.E. JACKSONS SUBDIVISION, according to map or plat thereof as recorded in Plat Book 2, Page 96 .of the Public Records of Hillsborough County, Florida, which Pinellas County was formerly a part. THIS DEED IS BEING RECORDED TO CORRECT DEED RECORDED IN OR 13163, PAGE 769, PUBLIC RECORDS PINELLAS COUNTY, FLORIDA. The property is not the homestead of the Grantor(s). To Have and to Hold, the above described premises, with the appurtenances, unto Buyer, Buyer's heirs and assigns forever. IN WITNESS WHEREOF, Seller has executed this deed under seal on the date aforesaid. Signed, Sealed and Delivered in Our Presence: Witness Signature: Witness Printed Name: Witness Signature: Witness Printed Name: 1M �2 , STATE OF FLORIDA COUNTY OF PINELLAS ETHEL LEE FAISON The foregoing instrument was acknowledged before me thisby ETHEL SIMS He/she is personally known t produced driver license(s) as identification.t aj .-Jcia.p„, 2d06 My Commission Expires: Printed Name: Notary Public SerialNumber e or has CHRIS RODBIGUEZ No Y.fubuc slate no . E is s 24 - 1/ 2/13/25, 11:58 AM Search > Account Summary Real Estate Account #R111822 Owner: Situs: Parcel details NSEND CURLENE 806 ENGMAN ST PropertyARpraiserG NETTIE B SIMS'CNAY-EST-- GLEARWATER) / 0 Homestead Exemption Pinellas uGet bills by emai Amount Due Your account is paid intuit. There is nothing due at this time. loud tpayoj twas made_o0.11/27/2024 (of$9�V9 52. [6 Apply for the 2025 installment payment plan Account History BILL AMOUNT DUE STATUS ACTION 2024Annua(Bill 0 50.00 Paid $949.52 11/27,2024 Receipt #0-24-137695 GI print (pp.F), 2023Annual Bill 0 $0.00 Paid $847.91 11/29/2023 Receipt #0-23-153103 0 Print PDF) 2022Annual Bill 0 $0.00 Paid $792.62 11/29/2022 Receipt 40-22-149759 l Print (PDF) 2021 Annual Bill 0 $0.00 Paid $620.33 11/22/2021 Receipt #917-21-001217 0 Print (PDF) 2020 Annual Bill 0 $0.00 Paid $584.74 11/30/2020 Receipt 80-20-118614 GI Prin (PDF . 2019 Annual Bill 0 $0.00 Paid $534.08 11/25/2019 Receipt #0-19-073718 ea Print (epi 2018 Annual Bill 0 $0.00 Paid 8457.36 11/29/2018 Receipt #0-18-064700 0 Print(PDF), 2017 Annual Bill 0 50.00 Paid $382.12 11/30/2017 Receipt #0-17-000646 Pi Print PDF 2016 Annual Bill (3 50.00 Paid $350.18 11/23/2016 Receipt #0-16-000513 0 Print PDF) 2015 Annual Bill 0 50.00 Paid $321.48 11/23/2015 Receipt #0-15-000546 0 Print (PDF) 2014 Annual Bili 0 $0.00 Paid 5303.15 11/21/2014 Receipt #0-14-000863 0 Print (P.:+F) 2013 Annual Bill 0 50.00 Paid $312.23 11/22/2013 Receipt #0-13-000668 0 Print PDF 2012Annual Bill 0 50.00 Paid $377.10 11/28/2012 Receipt #0-12-000613 0 Print PDF) 2011 Annual Bill 0 50.00 Paid $395.20 11/25/2011 Receipt #0-11-000160 0 Print PDF 2010 Annual Bill 0 $0:00 Paid $449.14 11/29/2010 Receipt #0-10-000279 0 Print PDF X009 Annual Bili 0 $0.00 Paid 5536.67 11/25/2009 Receipt #0-09-000134 0 Print PDF 2008 Annual Bill 0 $0.00 Paid $692.81 11/26/2008 Receipt #0-08-000089 0 Print PDF 2007 Annual Bill 0 50.00 Paid $765.58 11/29/2007 Receipt #075-07-00029226 0 Print (PDF) 2006 Annual Bill 0 $0.00 Paid $739.63 11/17/2006 Receipt #004-06-00002540 a Print (PDF) 2005 Annual Bill 0 $0.00 Paid 5439.11 02/28/2006 Receipt 8055-05-00190399 CD Print (PDF). 2004 Annual Bill 0 80.00 Paid $371.42 01/25/2005 Receipt #007-04-00021949 0 Print DF 2003 Annual Bill 0 50.00 No Balance Due 0 PrintPJLIE) 2002 Annual Bill 0 50.00 No Balance Due 0 print (PDF). 2002 Annual Bill 0 $0.00 No Balance Due ci Print (PDF), 2000 Annual Bill 0 $0.00 No Balance Due 0 Print (PDF) 1999 Annual Bill 0 50.00 No Balance Due 0 Print (PDF) Total Amount Due 50.00 https://cou nty-taxes.net/pinellas/property-tax/cG IuZWxsYXM6cmVhbF91c3RhdGU6cGFyZW5OczpiOTQyYzYyZC 1 IMzY4LTExZW ItOTRkMSOwM DUw... 1/1 yahoo!mail Search your mail 5 Inbox Starred Sent n Draftsj l�`J Folders E- Back E; LI u Q ••• .i. x Panel (vi Curlene Townsend To me • Mon, Nov 18 at 7:30 PM v Yahoo Mail: Search, Organize, Conquer Reply 4; Forward A Go back to the old Yahoo Mail Starred Contacts More L!VER Ask your doctor if yot could be at risk for M, yahoo!mail Search your mail Inbox Starred Sent n Drafts E:3 Folders (- Back <; A E; Xt Cj n Q Electric panel (vi Curlene Townsend To me• Mon, Nov 18 at 7:12 PM v Yahoo Mail: Search, Organize, Conquer Reply Forward A Go back to the old Yahoo Mail Starred Contacts More C Enable greater innovation by eliminating IT service outages. yahoolmail Search your mail Q Go back to the old Yahoo Mail C Inbox Starred Sent n Grafts Folders E— Back GA A E* drf O -•• T 4- X Pictures 6 Curlene Townsend To me• Mon, Nov 18 at 614 PM cu rlenetownsend@yahoo.com Starred Contacts More yahoo!mail Search your mail Inbox Starred Sent n Drafts Folders F Back 4;A A E * d n ••• Pictures Gv Curlene Townsend To me• Mon, Nov 18 at 712 PM v Q Go back to the old Yahoo Mail 4, X Starred Contacts More C yahoo mail Search your mail Inbox Starred Sent n Drafts Folders Back t;=k dJ E; d 12 Q ••• 4, X Front window (v Curlene Townsend To me•Mon, Nov18 at 7:06 PM Yahoo Mad: Search, Organize, Conquer Reply Forward W Go back to the old Yahoo Mail Starred Contacts More v C Curiene Townsend 20241118175035.jpg Pictures • Open message Photo 4 of 6 g yahoo/mail Search your mail Inbox Starred 4 Sent r Drafts Folders 4- Back El'Q Go back to the old Yahoo Mail C 4 rf O • • • 'is 4, X Kitchen window ei Curlene Townsend Tome•Mon, Nov 18 at711PM w Yahoo Mail: Search, Organize, Conquer Reply 4 Forward A Starred Contacts More Rapidly predict and prevent IT issues for 2 w 4� 4; !: t z �_ n sa 2023 Federal Tax Return Filing Instructions FOR THE YEAR ENDING December 31, 2023 Prepared for CURLENE S TOWNSEND Gross Income$92656 Adjusted Gross Income $92656 Total Deductions 1 $15700 Tax Total Taxable Income $76956 Summary Total Tax $12242 Total Payments $8927 Refund Amount $0 Amount You Owe $3315 Make check payable to Mailing Since you are filing your return electronically and you chose to use an Address electronic signature, you do not mail your return. Instructions If you e -filed your return and it has been accepted, you will get notified via text or email if you opted for that option. If you have a balance due being paid by check or are paper filing the return, mailit to the address indicated. Keep a copy of your return and supporting documents for your records. Checklist(2023) FDCHECKE-1WV 1.0 Form Software Copyright 1996 -2023 HRB Tax Group, Inc. INTERNAL REVENUE SERVICE P 0 Box 1214 Charlotte, NC 28201-1214 Fold here for #10 envelope INTERNAL REVENUE .SERVICE P 0 Box 1214 Charlotte, NC 28201-1214 Fold here for 6x9 envelope Fold here for #10 envelope FEDERAL SLIP SHEET FORM 1040 2023 TWO YEAR COMPARISON CURLENE S TOWNSEND Filing status Keep for Your Records 2023 2022 Difference Single Single INCOME: Wages, salaries, tips, etc 49,260 26,366 22,894 Interest income Ordinary dividend income IRA distributions and pension income 27,147 30,691 -3,544 Taxable social security inconie Capital gain or (loss) (Schedule D) Schedule 1 - Income Refunds of state and local taxes Alimony received Business income or (loss) (Schedule C) Other gains or (losses) (Form 4797) Rental real estate, partnerships, estates, etc. (Schedule E) Farm income or (loss) (Schedule F) Unemployment compensation Other income Total income ADJUSTMENTS: Schedule 1 - Adjustments Educator expenses Busn expenses for reserviists, performing artists, etc Health savings account deduction Moving expenses Deductible part of self-employment tax Self-employed SEP, SIMPLE and qualified plans deduction . . Self-employed health insurance Penalty on early withdrawal of savings Alimony paid IRA contributions Student loan interest deduction Archer MSA deduction Other adjustments Total adjustments ADJUSTED GROSS INCOME: 16,249 14,952 1,297 92,656 20,647 72,009 20,647 DEDUCTIONS: Standard deduction or Itemized deductions 15,700 14,700 1,000 Charitable contributions if taking standard deduction N/A If itemized, Schedule A deductions: Medical and dental expenses Sales, income, and other taxes paid 1,892 1,892 Interest paid 8,346 8,346 Gifts to charity 3,464 3,464 Casualty and theft losses Other miscellaneous deductions Qualified business income deduction TAXABLE INCOME: 76,956 57,309 19,647 FDA Form Software Copyright 1996— 2024 H RB Tax Group, Inc. A0509M 23_ANALYS 2023 TWO YEAR COMPARISON CURLENE S TOWNSEND Keep for Your Records. 2023 2022 Difference TAX COMPUTATION (BEFORE CREDITS): Tax 12,242 8,229 4,013 Tax calculation method TABLE Table Schedule 2 - Taxes Alternative minimum tax Excess advance premium tax credit repayment Total taxes 12,242 8,229 4,013 Tax rate 22% 22% CREDITS: Child and other dependents tax credit Schedule 3 - Non -Refundable Credits Foreign tax credit Child care credit Education credit Retirement savings contribution credit Other credits Total credits OTHER TAXES: Schedule 2 - Other Taxes Self-employment tax Additional tax on IRAs Other taxes TOTAL TAXES: PAYMENTS: Federal income tax withheld Estimated payments made Earned income credit Refundable child tax credit or additional child tax credit American opportunity credit Schedule 3 - Refundable Credits & Payments ACA premium tax credit Qualified sick and family leave credit Other payments Total payments 8,229 -8,229 8,229 -8,229 12,242 12,242 8,927 8,927 6,626 2,301 6,626 2,301 AMOUNT DUE / REFUND: Amount overpaid 6, 626 -6,626 Overpayment applied to next year Refund 6,626 -6,626 Amount due 3,315 3,315 Penalty Tax Calculation Methods: Sch D = Sch D tax worksheet QDCGTW = Qual Div Cap Gain Tax WS TCW = Tax Comp Worksheet (rates) Sch J = Inc Aver for Farmer/Fisherman F8615 = Child with unearned income TABLE = Tax Table FEITW = Foreign Earned Income Tax WS FDA Form Software Copyright 1996— 2024 HRB Tax Group, Inc. H0508M 23_ANALYS2 E Department.of the Treasury—Internal Revenue Service .61040 -SR U.S. Tax Return for Seniors 2023 OMB No. 1545-0074 IRS Use Only -Do not write or staple in this space. For the year Jan. 1 -Dec. 31, 2023, or other tax year beginning , 2023, ending , 20 See separate instructions. Your first name and middle initial CURLENE S Last name TOWNSEND Your social security number If joint return, spouse's first name and middle initial Last name Spouse's social security number Home address (number and street). If you have a P.O. box, see instructions. 806 ENGMAN S T Apt. no. Presidential Check here spouse if filing $3CLEARWATER Cheeockintotb Checking a not chap a refund. UYou Election if you, jointly, fb boo x beebelow your tax Campaign or your want will or 1 Spouse City, town, or post office. If you have a foreign address, also complete spaces below. State FL ZIP Code 33755 Foreign country name Foreign province/state/county Foreign postal code Filing Status Check only one box. z Single E Married filing jointly (even if only one had income) E Married filing separately (MFS) Head of household (HOH) 0 Qualifying surviving spouse (QSS) If you checked the MFS box, enter the name of your spouse. If you checked the HOH or QSS box, enter the child's name if the qualifying person is a child but not your dependent: Digital , At any time during 2023, did you: (a) receive (as a reward, award, or payment for Assets property or services); or (b) sell, exchange, or otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.) ElYes ® No Standard Someone can claim: 0 You as a dependent Q Your spouse as a dependent Deduction 0 Spouse itemizes on a separate return or you were a dual-status'afen You: X Were born before January 2, 1959 Are blind Age/Blindness — spouse: Was born before January 2, 1959 Is blind Dependents (see instructions): (1) First name If more than four dependents. see instructions and check here El (2) Social security no. Last name (3) Relationship to you (4) Check the box if qualifies for (see instructions : Child tax credit Creditfo other dependents Income Attach Form(s) W-2 here. Also attach Forms W -2G and _ 1099-R if tax was withheld. If you did not get.a Form W-2, see instructions. Attach Schedule B if required. 1a Total amount from Form(s) W-2, box 1 (see instruc ions) 1a 49, 260 b Household employee wages not reported on Form s) W-2 lb c Tip income not reported on line la (see instructions) 1 c d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) 1 d e Taxable dependent care benefits from Form 2441, line 26 1 e f Employer-provided adoption benefits from Form 8839, line 29 1f g Wages from Form 8919, line 6 1 q h Other earned income (see instructions) 1h 111 I i Nontaxable combat pay election (see instructions) z Add lines la through 1 h 2a Tax-exempt interest 3a Qualified dividends 4a IRA distributions 2a 3a 4a lz 49,260 b Taxable interest 2b b Ordinary dividends 3b b Taxable amount 4b 500 5a Pensions and annuities 5a b Taxable amount 5b 26, 647 6a Social security benefits.. 6a 19, 116 b Taxable amount 6b c If you elect to use the lump -sum election method, check here (see instructions).. � 1 16, 249 For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. GEB 23 1040SR1 TXO 1040 Form Software Copyright 1996— 2024 HRB Tax Group, Inc. Form 1040 -SR (2023) Form 1040 -SR (2023) CURLENE S TOWNSEND 7 8 9 10 Standard 11 Deduction 12 See Standard Deduction Chart on the last page of this form. 13 14 15 Capital gain or (loss). Attach Schedule D if required. If not required, check here Additional income from Schedule 1, line 10 Page 2 El Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income Adjustments to income from Schedule 1, line 26 Subtract line 10 from line 9. This is your adjusted gross income Standard deduction or itemized deductions (from Schedule A) Qualified business income deduction from Form 8995 or Form 8995-A Add lines 12 and 13 Subtract line 14 from line 11. If zero or Tess, enter -0-. This is your taxable income 7 8 9 92,656 10 11 12 92,656 15,700 13 14 15,700 15 76,956 Tax and 16 Credits Payments If you have a qualifying child, attach Sch. EIC. 17 18 19 20 21 22 23 24 25 a b c d 26 27 28 29 30 31 32 Tax (see instructions). Check if any from: 1 0 Form(s) 8814 2 Q Form 4972 3 Q Amount from Schedule 2, line 3 Add lines 16 and 17 Child tax credit or credit for other dependents from Schedule 8812 Amount from Schedule 3, line 8 Add lines 19 and 20 Subtract line 21 from line 18. If zero or less, enter -0- Other taxes, including self-employment tax, from Schedule 2, line 21 Add lines 22 and 23. This is your total tax 16 12,242 17 18 12,242 19 20 21 22 12,242 23 24 12,242 Federal income tax withheld from: Form(s) W-2 Form(s) 1099 Other forms (see instructions) Add lines 25a through 25c 2023 estimated tax payments and amount applied from 2022 return 25a 6,579 25b 2,348 25c Earned income credit (EIC) 27 Additional child tax credit from Schedule 8812 American opportunity credit from Form 8863, line 8 Reserved for future use Amount from Schedule 3, line 15 Add lines 27, 28,29,and 31.These are your total other payments and refundable credits 33 Add lines 25d, 26, and 32. These are your total payments 28 29 30 31 25d 8,927 26 32 33 8,927 Go to www.irs.gov/Form1040SR for instructions and the latest information. GEB 23 1040SR2 TXO 1040 Form Software Copyright 1996— 2024 HRB Tax Group, Inc. Form 1040 -SR (2023) Form 1040 -SR (2023) CURLENE S TOWNSEND Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid 35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here Direct deposit? b Routing number XXXXXXXXXXXXXXXXXX c Type: Q Checking 0 Savings See instructions. d Account number XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 36 Amount of line 34 you want applied to your 2024 estimated tax .... Amount 37 Subtract line 33 from line 24. This is the amount you owe. You Owe For details on how to pay, go to www.irs.gov/Payments or see instructions 38 Estimated tax penalty (see instructions) 138 Page 3 36 34 35a 37 3,315 Third Party Designee Do you want to allow another person to discuss this retum with the IRS? See instructions Designee's name Phone no. ['Yes. Complete below. ® No Personal identification number (PIN) Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to Here the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Your signature Date Your occupation Joint return? See instructions. Keep a copy for your records. CORRECTIONS Spouse's signature. If a joint return, both must sign. Date Spouse's occupation If the IRS sent you an Identity Protection PIN, enter it here (see inst.) If the IRS sent your spouse an Identity Protection PIN, enter it here (see inst.) Phone no. 7274034788 Paid Preparer's name Preparer Use Only Firm's name Email address curlenetownsend@yahoo . com Preparer's signature Date PTIN Check if: I I Self-employed Phone no. Firm's address Firm's EIN Go to www.irs.gov/Form1040SR for instructions and the latest information. Form 1040 -SR (2023) GEB 23 1040SR3 TXo 1040 Form Software Copyright 1996 — 2024 HRB Tax Group, Inc. Form 1040 -SR (2023) CURLENE S TOWNSEND Page 4 Standard Deduction Chart* Add the number of boxes checked in the "Age/Blindness" section of Standard Deduction on page 1 1 IF your filing status is... AND the number of THEN your standard boxes checked is... deduction is... Single 1 $15,700 2 17,550 1 $29,200 Married 2 30,700 filing jointly 3 32,200 4 . 33,700 Qualifying 1 $29,200 surviving spouse 2 30,700 Head of 1 $22,650 household 2 24,500 1 $15,350 Married filing 2 16,850 separately** 3 18,350 4 19,850 *Don't use this chart if someone can claim you (or your spouse if filing jointly) as a dependent, your spouse itemizes on a separate return, or you were a dual -status alien. Instead, see instructions. **You can check the boxes for your spouse if your filing status is married filing separately and your spouse had no income, isn't filing a return, and can't be claimed as a dependent on another person's return. Go to www.irs.gov/Form104OSR for instructions and the latest information. Form 1040 -SR (2023) GEB 23 1040SR4 TXO 1040 Form Software Copyright 1996— 2024 HRB Tax Group, Inc. 2023 WAGES AND SALARIES SUMMARY ATTACHMENT CURLENE S TOWNSEND GOODWILL INDUSTRIES Total FDA 59-0718492, T Form Software Copyright 1996— 2024 HRB Tax Group, Inc. 49,260 6,579 3,182 FL 49,260 6,579 3,182 H05080 23 W2LO T Federal Social Security State State Local Employer Name Employer EIN or Wages Withholding Tax Withheld State Wages Tax Withheld Tax Withheld GOODWILL INDUSTRIES Total FDA 59-0718492, T Form Software Copyright 1996— 2024 HRB Tax Group, Inc. 49,260 6,579 3,182 FL 49,260 6,579 3,182 H05080 23 W2LO 2023 PENSIONS AND ANNUITIES SUMMARY ATTACHMENT CURLENE S TOWNSEND Payer Name Payer's Federal EIN T Or S Pension Amount Taxable Amount Capital Gain Incl in Box 2a Federal Tax Withheld Distrib Code IPDA/ SEP / SMPL State State Tax Withheld Local Tax Withheld PINELLAS FEDERAL CRE 59-0919852 T FLORIDA RETIREMENT S 59-1354377 T TOTAL 1099RS 500 26, 647 27,147 FDA Form Software Copyright 1996— 2024 HRB Tax Group, Inc. H05080 500 26,647 7 X 2,348 7 27,147 2,348 FL 23_W2PLO 2023 FEDERAL TAX WITHHOLDINGS ATTACHMENT CURLENE S TOWNSEND W-2 GOODWILL INDUSTRIES 1099R FLORIDA RETIREMENT SYSTEM 6,579 2,348 Total to Form 1040/1040 -SR line 25d 8,927 FDA Form Software Copyright 1996— 2024 HRB Tax Group, Inc. H05080 23_TXFEDWH c 2023 SOCIAL SECURITY TAXABLE BENEFITS WORKSHEET CURLENE S TOWNSEND Before you begin: Keep for Your Records Publication 915 ,/ If you are married filing separately and you lived apart from your spouse for all of 2023, enter "0" to the right of the word "benefits" on Form 1040 or 1040 -SR, line 6a. J Don't use this worksheet if you repaid benefits in 2023 and your total repayments (box 4 of Forms SSA -1099 and RRB-1099) were more than your gross benefits for 2023 (box 3 of Forms SSA -1099 and RRB-1099). None of your benefits are taxable for 2023. For more information, see "Repayments More Than Gross Benefits" in Pub 915. J If you are filing Form 8815, Exclusion of Interest From Series EE and I U.S. Savings Bonds Issued After 1989, do not include the amount from line 2b of Form 1040 on line 3 of this worksheet. Instead, include the amount from Schedule B (Form 1040 or 1040 -SR), line 2. 1. Enter the total amount from box 5 of ALL your Forms SSA -1099 and Forms RRB-1099. Also enter this amount on Form 1040 or 1040 -SR, line 6a 1. 19,116 2. Multiply line 1 by 50% (0.50) 2. 9,558 3. Combine the amounts from: Form 1040 or 1040 -SR , lines 1z, 2b, 3b, 4b, 5b, 7, and 8. - 3. 76,407 4. 4. Enter the amount, if any, from Form 1040 or 1040 -SR line 2a 5. Enter the total of any exclusions/adjustments for: • Adoption benefits (Form 8839, line 28) • Foreign earned income or housing (Form 2555, lines 45 and 50), and • Certain income of bona fide residents of American Samoa (Form 4563, line 15) or Puerto Rico 6. Combine lines 2, 3, 4, and 5 5. 6. 7. Form 1040 filers: Enter the amounts from Schedule 1, lines 11 through 20, and 23 and 25 7. 8. Is the amount on line 7 less than the amount on line 6? No. STOP None of your social security benefits are taxable. Enter -0- on Form 1040 or 1040 -SR, line 6b 85,965 Yes. Subtract line 7 from line 6 8. 85,965 9. If you are: • Married filing jointly, enter $32,000 • Single, head of household, qualifying surviving spouse, or married filing separately and you lived apart from your spouse for all of 2023, enter $25,000 9. _2 5 , 0 0 0 Note: If you are married filing separately and you lived with your spouse.at any time in 2023, skip lines 9 through 16; multiply line 8 by 85% (0.85) and enter the result on line 17. Then go to line 18. Is the amount on line 9 less than the amount on line 8? 10. No. STOP None of your benefits are taxable. Enter -0- on Form 1040 or 1040 -SR, line 6b. If you are married filing separately and you lived apart from your spouse for all of 2023, be sure you entered "D" to the right of the word "benefits" on Fm 1040 or 1040 -SR, line 6a. Yes. Subtract line 9 from line 8 10. 60,965 11. Enter: $12,000 if married filing jointly; $9,000 if single, head of household, qualifying surviving spouse, or married filing separately and you lived apart from your spouse for all of 2023 11. 9,000 12. Subtract line 11 from line 10. If zero or less, enter -0- 12. 51, 965 13. Enter the smaller of line 10 or line 11 13. 9,000 14. Multiply line 13 by 50% (0.50) 14. 4,500 15. Enter the smaller of line 2 or line 14 15. 4,500 16. Multiply line 12 by 85% (0.85). If line 12 is zero, enter -0- 16. 4 4 , 17 0 17. Add lines 15 and 16 17. 48, 670 18. Multiply line 1 by 85% (0.85) 18. 16,249 19. Taxable benefits. Enter the smaller of line 17 or line 18. Also enter this amount on Form 1040 or 1040 -SR line 6b 19. 16 , 249 TIP: If you received a lump -sum payment in 2023 that was for an earlier year, also complete Worksheet 2 or 3 and Worksheet 4 to see if you can report a lower taxable benefit. FDA Form Software Copyright 1996-2024 HRB Tax Group, Inc. H05080 23_SSO A voucher is printed at the bottom of this page. NOTE: This is a new scannable voucher approved by the IRS for filing of the 1040-V for the year 2023. This is different than the voucher that is on the IRS website. ► Use this voucher when making a payment with Form 1040. ► Do not staple this voucher or your payment to Form 1040. ► Make your check or money order payable to the "United States Treasury". ► Write your Social Security Number (SSN) on your check or money order. Mail payment to: INTERNAL REVENUE SERVICE P 0 Box 1214 Charlotte, NC 28201-1214 Form Software Copyright 1996- 2024 H RB Tax Group, Inc. 23 1040VS1 Txo 1040 Separate here and mail with your payment and return. Form 1040-V (2023) department of. the•Treaury; nternal RevenueSService men 0 ► Use Form 1040-V when paying the balance due on Form 1040, Form 1040A, 1040EZ, or 1040NR. ► Enter your SSN on your check or money order ► If your name, address, or SSN is incorrect, see instructions. 1 NMtit `. CURLENE S TOWNSEND 806 ENGMAN ST CLEARWATER, FL 33755 Amount you are paying by check or money order.Make your check or money order payable to "United States Treasury" Dollars 3,315 1729 For Privacy Act and Paperwork Reduction Act Notice, see instructions. INTERNAL REVENUE SERVICE P 0 Box 1214 Charlotte, NC 28201-1214 CI TOWN 30 0 202312 610 S 2224 CARRYFORWARD INFORMATION CURLENE S TOWNSEND Itemized Returns Only - 2023 state and local tax refund (this amount may not be taxable in 2024) Charitable contributions carryover to 2024 Estimated short-term capital loss carryover Estimated long-term capital loss carryover 2023 tax liability (for 2024 Form 2210 purposes) Form 8839: 2022 carryover of unqualified expenses Refund amount applied to 2024 Disallowed investment interest in 2023 Additional state taxes paid Form 8396: Mortgage interest credit from 2021 Mortgage interest credit from 2022 . Mortgage interest credit from 2023 Form 8801: Minimum tax credit carryforward Potential 2024 IRA contribution from 2023 tax refund NOL carryforward: from 2003 from 2004 from 2005 from 2006 from 2007 from 2008 from 2009 from 2010 from 2011 from 2012 Regular Tax from 2013 from 2014 from 2015 from 2016 from 2017 from 2018 from 2019 from 2020 from 2021 from 2022 Gross NOL generated in 2023 To be absorbed in carryback period Net carryforward from 2023 Total carryforward to 2024 Keep for Your Records 12,242 0 AMT Tax from 2003 from 2013 from 2004 from 2014 from 2005 from 2015 from 2006 from 2016 from 2007 from 2017 from 2008 from 2018 from 2009 from 2019 from 2010 from 2020 from 2011 from 2021 from 2012 from 2022 Gross AMT NOL generated in 2023 To be absorbed in carryback period . Net carryforward from 2023 Total carryforward to 2024 • The amounts carried to next year from Schedule(s) E, pages 1 and/or 2, are found on Form 8582, Worksheet 6. Carryover AMT amounts are found on the AMT Form 8582, Worksheet 6. • Foreign Tax Credit carryforward to 2024 • General Business Credit carryforward to 2024 • First -Time Homebuyer Credit Repayment carryforward to 2024 • If there are Form(s) 6252 in this tax return, the gross profit ratio and prior payments received (including the current year payments) will carry forward from each Form 6252. • Amounts from Form 6251, lines 16 through 18, lines 27 and 28 are automatically carried forward to 2024. FDA Form Software Copyright 1996— 2024 H RB Tax Group, Inc. H0508M 23_CRYFWD 2022 Federal Tax Return Filing Instructions FOR THE YEAR ENDING December 31, 2022 Prepared for CURLENE S TOWNSEND Tax Summary Gross Income $72009 Adjusted Gross Income $72009 Total Deductions $14700 Total Taxable Income $57309 Total Tax $0 Total Payments $6626 Refund Amount $6626 Amount You Owe $0 Make check payable to Mailing Address Since you are filing your return electronically and you chose to use an electronic signature, you do not mail your return. Instructions If you e -filed your return and it has been accepted, you will get notified via text or email if you opted for that option. Checklist(2022) FDCHECKE-1 WV 1.0 Form Software Copyright 1996 - 2022 HRB Tax Group, Inc. 2022 REFUND TRANSFER INFORMATION CURLENE S TOWNSEND Keep for Your Records IRS Direct Deposit Information Routing Transit Number (RTN) Depositor Account Number (DAN) Refund Transfer Proceeds - Direct Deposit Information Routing Transit Number (RTN) Depositor Account Number (DAN) GEB Form Software Copyright 1996— 2022 FIRE Tax Group, Inc. K0505S 22 REFUNDTRANSFER 2022 TWO YEAR COMPARISON CURLENE S TOWNSEND Filing status Keep for Your Records 2022 2021 Difference Single Single INCOME: Wages, salaries, tips, etc. 26,366 26,366 Interest income Ordinary dividend income IRA distributions and pension income 30,691 30,691 Taxable social security income 14,952 14,952 Capital gain or (loss) (Schedule D) Schedule 1 - Income Refunds of state and local taxes Alimony received Business income or (loss) (Schedule C) Other gains or (losses) (Form 4797) Rental real estate, partnerships, estates, etc. (Schedule E) Farm income or (loss) (Schedule F) Unemployment compensation Other income Total income 72,009 72,009 ADJUSTMENTS: Schedule 1 - Adjustments Educator expenses Busn expenses for reserviists, performing artists, etc Health savings account deduction Moving expenses Deductible part of self-employment tax Self-employed SEP, SIMPLE and qualified plans deduction Self-employed health insurance Penalty on early withdrawal of savings Alimony paid IRA contributions Student loan interest deduction Archer MSA deduction Other adjustments Total adjustments ADJUSTED GROSS INCOME: DEDUCTIONS: Standard deduction or Itemized deductions Charitable contributions if taking standard deduction If itemized, Schedule A deductions: Medical and dental expenses Sales, income, and other taxes paid Interest paid Gifts to charity Casualty and theft losses Other miscellaneous deductions Qualified business income deduction TAXABLE INCOME: GEB Form Software Copyright 1996-2023 HRB Tax Group, Inc. S0505S 72,009 14,700 N/A 72,009 14,700 783 783 4,334 4,334 2,400 2,400 57,309 57,309 22_ANALYS 2022 TWO YEAR COMPARISON CURLENE S TOWNSEND Keep for Your Records 2022 2021 Difference TAX COMPUTATION (BEFORE CREDITS): Tax 8,229 8,229 Tax calculation method TABLE Schedule 2 - Taxes Alternative minimum tax Excess advance premium tax credit repayment Total taxes 8,229 8, 229 Tax rate 22% CREDITS: Child and other dependents tax credit Schedule 3 - Non -Refundable Credits Foreign tax credit Child care credit Education credit Retirement savings contribution credit Other credits 8,229 8,229 Total credits 8,229 8,229 OTHER TAXES: Schedule 2 - Other Taxes Self-employment tax Additional tax on IRAs Other taxes TOTAL TAXES: PAYMENTS: Federal income tax withheld Estimated payments made Earned income credit Refundable child tax credit or additional child tax credit American opportunity credit Recovery rebate credit Schedule 3 - Refundable Credits & Payments ACA premium tax credit Qualified sick and family leave credit Deferral for certain Schedule H or Schedule SE filers Other payments Total payments 6,626 6,626 N/A 6,626 6,626 AMOUNT DUE / REFUND: Amount overpaid 6, 626 6, 626 Overpayment applied to next year Refund 6', 626 6,626 Amount due Penalty Tax Calculation Methods: Sch D = Sch D tax worksheet QDCGTW = Qual Div Cap Gain Tax WS TCW = Tax Comp Worksheet (rates) Sch J = Inc Aver for Farmer/Fisherman F8615 = Child with unearned income TABLE = Tax Table FEITW = Foreign Earned Income Tax WS GEB Form Software Copyright 1996-2023 HRB Tax Group, Inc. S10030 22_ANALYS2 E Department of the Treasury—Intemal Revenue Service '61040 -SR U.S. Tax Return for Seniors Filing Status Check only one box. 2[22 OMB No. 1545-0074 ZX Single Married filing jointly Married filing _ Head of household (HOH) Qualifying surviving spouse (QSS) If you checked the MFS box, enter the name of your spouse. If you checked the HOH name if the qualifying person is a child but not your dependent: IRS Use Only -Do not write or staple in this space. separately (MFS) or QSS box, enter the child's Your first name and middle initial CURLENE S Ifjoint retum, spouse's first name and middle initial Last name TOWNSEND Last name Your social security number Spouse's social security number Home address (number and street). If you have a P.O. box, see instructions. 806 ENGMAN ST Apt. no. City, town, or post office. If you have a foreign address, also complete spaces below. CLEARWATER' State FL ZIP code 33755 Foreign country name Foreign province/state/county Foreign postal code Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not chana your tax or refund. UYou 0Spouse Digital Assets At any time during 2022, did you: (a) receive (as a reward, award, or payment for property or services); or (b) sell, exchange, gift, or otherwise dispose of a digital asset (or a financial interest in a digital asset)? (See instructions.) QYes 0 No Standard Someone can claim: You as a dependent 11 Your spouse as a dependent Deduction Q Spouse itemizes on a searate return or you were a dual -status alien You: X Were born before January 2, 1958 Are blind Age/Blindness [Spouse: Was born before January 2, 1958 Is blind Dependents (see instructions): (1) First name If more than four dependents, see instructions and check here (2) Social security no. Last name (3) Relationship to you (4) Check the box if qualifies for (see instructions): Child tax credit Credit for other dependents Income Attach Form(s) W-2 here. Also attach Forms W -2G and 1099-R if tax was withheld. If you did not get a Form W-2, see instructions. Attach Schedule B if required. la Total amount from Form(s) W-2, box 1 (see instructions) b Household employee wages not reported on Form(s) W-2 c Tip income not reported on line la (see instructions) d Medicaid waiver payments not reported on Form(s) W-2 (see instructions) e Taxable dependent care benefits from Form 2441, line 26 f Employer-provided adoption benefits from Form 8839, line 29 g Wages from Form 8919, line 6 h Other earned income (see instructions) Ili i Nontaxable combat pay election (see instructions) z 2a 3a 4a 5a Add lines 1a through 1h Tax-exempt interest Qualified dividends IRA distributions Pensions and annuities 2a 3a 4a 5a 1a 26,366 1b lc 1d 1e 1f 1g 1h b Taxable interest b Ordinary dividends b Taxable amount b Taxable amount 6a Social security benefits.. 6a 17,591 b Taxable amount c If you elect to use the lump -sum election method, check here (see instructions).. 7 Capital gain or (loss). Attach Schedule D if required. If notrequired, check here For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. GEB 22 1040SR1 Txo 1040 Form Software Copyright 1996- 2023 HRB Tax Group, Inc. t I. 1z 2b 3b 4b 5b 6b 26, 366 5,089 25, 602 14, 952 7 Form 1040 -SR (2022) Form 1040 -SR (2022) CURLENE S TOWNSEND 8 Other income from Schedule 1, line 10 9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income 10 Adjustments to income from Schedule 1, line 26 Standard 11 Subtract line 10 from line 9. This is your adjusted gross income Deduction 12 Standard deduction or itemized deductions (from Schedule A) See Standard Deduction Chart on the last page of this form. 13 Qualified business income deduction from Form 8995 or Form 8995-A 14 Add lines 12 and 13 15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income 8 9 10 11 12 13 14 15 Tax and 16 Tax (see instructions). Check if any from: Credits 1 0 Form(s) 8814 2 Q Form 4972 3 Q 17 Amount from Schedule 2, line 3 18 Add lines 16 and 17 19 Child tax credit or credit for other dependents from Schedule 8812 20 Amount from Schedule 3, line 8 21 Add lines 19 and 20 22 Subtract line 21 from line 18. If zero or less, enter -0- 23 Other taxes, including self-employment tax, from Schedule 2, line 21 24 Add lines 22 and 23. This is your total tax Payments 25 Federal income tax withheld from: a Form(s) W-2 25a 3, 922 b Form(s) 1099 c Other forms (see instructions) d Add lines 25a through 25c 25b 2,704 If you have a qualifying child, attach Sch. EIC. 25c 26 2022 estimated tax payments and amount applied from 2021 return 27 Earned income credit (EIC) 27 28 Additional child tax credit from Schedule 8812 29 American opportunity credit from Form 8863, line 8 30 Reserved for future use t.. 31 Amount from Schedule 3, line 15 32 Add lines 27, 28,29,and 31.These are your total other payments and refundable credits 33 Add lines 25d, 26, and 32. These are your total payments 28 29 30 31 16 17 18 19 20 21 22 23 24 Page 2 72,009 72,009 14,700 14,700 57,309 8,229 8,229 8,229 8,229 0 0 25d 6,626 26 32 33 6,626 Go to www.irs.gov/Form1040SR for instructions and the latest information. Form 1040 -SR (2022) GEB 22 1040SR2 TXO 1040 Form Software Copyright 1996— 2023 HRB Tax Group, Inc. Form 1040 -SR (2022) CURLENE S TOWNSEND Page 3 Refund 34 If line 33 is more than line 24, subtract line 24 from line 33. This is the amount you overpaid. 35a Amount of line 34 you want refunded to you. If Form 8888 is attached, check here Q Direct deposit? b Routing number c Type: ® Checking 0 Savings See instructions. d Account number 36 Amount of line 34 you want applied to your 2023 estimated tax .. 36 34 6, 626 35a 6, 626 Amount 37 Subtract line 33 from line 24. This is the amount you owe. You Owe For details on how to pay, go to www.irs.gov/Payments or see instructions 38 Estimated tax penalty (see instructions) 138 Third Party Do you want to allow another person to discuss this return with the IRS? See Designee instructions Designee's name 7 QYes. Complete below. ® No Phone Personal identification no. number (PIN) Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to Here the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based cin all information of which. re. arer has any knowledge. Your signature Joint Seinstructions. turn? See ins Date Your occupation If the IRS sent you an Identity Protection PIN, enter it here CORRECTIONS (see inst.) Keep a copy for Spouse's signature. If a joint return, both must sign. your records. Date Spouse's occupation If the IRS sent your spouse an Identity Protection PIN, enter it here (see inst.) Phone no. 727-403-4788 Email address- curlenetownsend@yahoo . tom Paid Preparer's name Preparer Use Only Preparer's signature . Date PTIN Check if: [ Self-employed Firm's name Phone no. Firm's address Firm's EIN Go to www.irs.gov/Form1040SR for instructions and the latest information. GEB 22 1040SR3 TXO 1040 Form Software Copyright 1996 — 2023 HRB Tax Group, Inc. Form 1040 -SR (2022) Form 1040 -SR (2022) CURLENE S TOWNSEND Page 4 Standard Deduction Chart* Add the number of boxes checked in the "Age/Blindness" section of Standard Deduction on page 1 IF your filing status is... AND the number of THEN your standard boxes checked is... deduction is... Single 1 $14,700 2 16,450 1 $27,300 Married 2 28,700 filing jointly 3 30,100 4 31,500 Qualifying 1 $27,300 surviving spouse 2 28,700 Head of 1 $21,150 household 2 22,900 1 $14,350 Married filing 2 15,750 separately** 3 17,150 4 18,550 *Don't use this chart if someone can claim you (or your spouse if filing jointly) as a dependent, your spouse itemizes on a separate return, or you were a dual -status alien. Instead, see instructions. **You can check the boxes for your spouse if your filing status is married filing separately and your spouse had no income, isn't filing a return, and can't be claimed as a dependent on another person's return. Go to www.irs.gov/Form104OSR for instructions and the latest information. Form 1040 -SR (2022) GEB 22 1040SR4 TXO 1040 Form Software Copyright 1996— 2023 HRB Tax Group, Inc. SCHEDULE 3 (Form 1040) Department of the Treasury Internal Revenue Service Additional Credits and Payments Attach to Form 1040, 1040 -SR, or 1040 -NR. Go to www.irs.gov/Form1040 for instructions and the latest information. OMB No. 1545-0074 2022 Attachment Sequence No. 03 Name(s) shown on Form 1040, 1040 -SR, or 1040 -NR CURLENE S TOWNSEND Part I Your social security number Nonrefundable Credits 1 Foreign tax credit. Attach Form 1116 if required 2 Credit for child and dependent care expenses from Form 2441, line 11. Attach Form 2441 3 Education credits from Form 8863, line 19 4 Retirement savings contributions credit. Attach Form 8880 5 Residential energy credits. Attach Form 5695 6 Other nonrefundable credits: a General business credit. Attach Form 3800 b Credit for prior year minimum tax. Attach Form 8801 c Adoption credit. Attach Form 8839 d Credit for the elderly or disabled. Attach Schedule R e Alternative motor vehicle credit. Attach Form 8910 f Qualified plug-in motor vehicle credit. Attach Form 8936 g Mortgage interest credit. Attach Form 8396 h District of Columbia first-time homebuyer credit. Attach Form 8859 i Qualified electric vehicle credit. Attach Form 8834 j Alternative fuel vehicle refueling property credit. Attach Form 8911 k Credit to holders of tax credit bonds. Attach Form 8912 1 Amount on Form 8978, line 14. See instructions z Other nonrefundable credits. List type and amount: 7 Total other nonrefundable credits. Add lines 6a through 6z 6a 1 2 3 4 5 8, 229 6b 6c 6d 6e 6f 6g 6h 6i 6j 6k 61 6z 8 Add lines 1 through 5 and 7. Enter here and on Form 1040, 1040 -SR, or 1040 -NR, line 20 7 8 8,229 (continued on page 2) For Paperwork Reduction Act Notice, see your tax return instructions. GEB 22 1040SCH3 TXO 1040 Form Software Copyright 1996- 2023 HRB Tax Group, Inc. Schedule 3 (Form 1040) 2022 Schedule 3 (Form 1040) 2022 CURLENE S TOWNSEND Part II 9 10 11 12 13 a b Page 2 Other Payments and Refundable Credits Net premium tax credit. Attach Form 8962 Amount paid with request for extension to file (see instructions) Excess social security and tier 1 RRTA tax withheld Credit for federal tax on fuels. Attach Form 4136 Other payments or refundable credits: Form 2439 Credit for qualified sick and family leave wages paid in 2022 from Schedule(s) H for leave taken before April 1, 2021 c Reserved for future use d Credit for repayment of amounts included in income from earlier years e Reserved for future use f Deferred amount of net 965 tax liability (see instructions) g Reserved for future use h Credit for qualified sick and family leave wages paid in 2022 from Schedule(s) H for leave taken after March 31, 2021, and before October 1, 2021 z Other payments or refundable credits. List type and amount: 14 Total other payments or refundable credits. Add lines 13a through 13z 13a 9 10 11 12 13b 13c 13d 13e 13f 13g 13h 13z 15 Add lines 9 through 12 and 14. Enter here and on Form 1040, 1040 -SR, or 1040 -NR, line 31 14 15 Schedule 3 (Form 1040) 2022 GEB 22 1040SCH32 TXO 1040 Form Software Copyright 1996 — 2023 HRB Tax Group, Inc. Form 5695 Department of the Treasury Internal Revenue Service Residential Energy Credits Go to www.irs.gov/Form5695 for instructions and the latest information. Attach to Form 1040, 1040 -SR, or 1040 -NR. OMB No. 1545-0074 2022 Attachment Sequence No. 158 Name(s) shown on return CURLENE S TOWNSEND Part I Your social security number Residential Clean Energy Credit (See instructions before completing this part.) Note: Skip lines 1 through 11 if you only have a credit carryforward from 2021. 1 Qualified solar electric property costs 2 Qualified solar water heating property costs 3 Qualified small wind energy property costs 4 Qualified geothermal heat pump property costs 5 Qualified biomass fuel property costs 6a Add lines 1 through 5 b Multiply line 6a by 30% (0.30) 7a Qualified fuel cell property. Was qualified fuel cell property installed on, or in connection with, your main home located in the United States? (See instructions.) Caution: If you checked the "No" box, you cannot take a credit for qualified fuel cell property. Skip lines 7b through 11. b Print the complete address of the main home where you installed the fuel cell property. Number and street Unit No. City, State, and ZIP code 8 Qualified fuel cell property costs 8 9 Multiply line 8 by 30% (0.30) 10 Kilowatt capacity of property on line 8 above ... x $1,000 11 Enter the smaller of line 9 or line 10 12 Credit carryforward from 2021. Enter the amount, if arty, from your 2021 Form 5695, line 16 13 Add lines 6b, 11, and 12 14 Limitation based on tax liability. Enter the amount from the Residential Clean Energy Credit Limit Worksheet (see instructions) 15 Residential clean energy credit. Enter the smaller of line 13 or line 14. Also include this amount on Schedule 3 (Form 1040), line 5 16 Credit carryforward to 2023. If line 15 is less than line 13, subtract line 15 from line 13 16 9 10 13,371 1 71,000 2 3 4 5 6a 6b 7a 71,000 21,300 0 Yes Q No 11 12 13 21,300 14 7,929 15 7, 929 For Paperwork Reduction Act Notice, see your tax return instructions. GEB 22 56951 TXO 1040 Form Software Copyright 1996- 2023 H RB Tax Group, Inc. Form 5695 (2022) Form 5695 (2022) CURLENE S TOWNSEND Page 2 Part 11 Energy Efficient Home Improvement Credit 17a Were the qualified energy efficiency improvements or residential energy property costs for your main home located in the United States? (see instructions) Caution: If you checked the "No" box, you cannot claim the energy efficient home improvement credit. Do not complete Part II. b Print the complete address of the main home where you made the qualifying improvements. Caution: You can only have one main home at a time. 806 ENGMAN ST Number and street Unit No. CLEARWATER FL 33755 City, State, and ZIP code c Were any of these improvements related to the construction of this main home? Caution: If you checked the "Yes" box, you can only claim the energy efficient home improvement credit for qualifying improvements that were not related to the construction of the home. Do not include expenses related to the construction of your main home, even if the improvements were made after you moved into the home. 18 Lifetime limitation. Enter the amount from the Lifetime Limitation Worksheet (see instructions) 19 Qualified energy efficiency improvements (original use must begin with you and the component must reasonably be expected to last for at least 5 years; do not include labor costs) (see instructions). a Insulation material or system specifically and primarily designed to reduce heat loss or gain of your home that meets the prescriptive criteria established by the 2009 IECC b Exterior doors that meet or exceed the version 6.0 Energy Star program requirements c Metal or asphalt roof that meets or exceeds the Energy Star program requirements and has appropriate pigmented coatings or cooling granules which are specifically and primarily designed to reduce the heat gain of your home d Exterior windows and skylights that meet or exceed the version 6.0 Energy Star program requirements e Maximum amount of cost on which the credit can be figured f If you claimed window expenses on your Form 5695 prior to 2022, enter the amount from the Window Expense Worksheet (see instructions); otherwise enter -0- g Subtract line 19f from line 19e. If zero or less, enter -0- h Enter the smaller of line 19d or line 19g 19d 17a }' Yes n No 17c nYes ; No 18 19a 19b 19c 19e $2,000 19f 0 19g 2,000 20 Add lines 19a, 19b, 19c, and 19h 21 Multiply line 20 by 10% (0.10) 22 Residential energy property costs (must be placed in service by you; include labor costs for onsite preparation, assembly, and original installation) (see instructions). a Energy-efficient building property. Do not enter more than $300 b Qualified natural gas, propane, or oil furnace or hot water boiler. Do not enter more than $150 c Advanced main air circulating fan used in a natural gas, propane, or oil furnace. Do not enter more than $50 23 Add lines 22a through 22c 24 Add lines 21 and 23 25 Maximum credit amount. (If you jointly occupied the home, see instructions) 26 Enter the amount, if any, from line 18 27 Subtract line 26 from line 25. If zero or less, stop; you cannot take the energy efficient home improvement credit 28 Enter the smaller of line 24 or line 27 29 Limitation based on tax liability. Enter the amount from the Energy Efficient Home Improvement Credit Limit Worksheet (see instructions) 30 Energy efficient home improvement credit. Enter the smaller of line 28 or line 29. Also include this amount on Schedule 3 (Form 1040), line 5 19h 20 21 22a 300 22b 22c 23 24 25 300 300 $500 26 27 500 28 300 29 8,229 30 GEB 22 56952 TXO 1040 Form Software Copyright 1996— 2023 HRB Tax Group, Inc. 300 Form 5695 (2022) 2022 WAGES AND SALARIES SUMMARY ATTACHMENT CURLENE S TOWNSEND GOODWILL INDUSTRIES Total 59-0718492 T 26,366 3,922 1,658 FL 26,366 3,922 1,658 GEB Form Software Copyright 1996 — 2023 1 -IRB Tax Group, Inc. V0505D 22_W2LO T Federal Social Security State State Local Employer Name Employer EIN or Wages Withholding Tax Withheld State Wages Tax Withheld Tax Withheld GOODWILL INDUSTRIES Total 59-0718492 T 26,366 3,922 1,658 FL 26,366 3,922 1,658 GEB Form Software Copyright 1996 — 2023 1 -IRB Tax Group, Inc. V0505D 22_W2LO 2022 PENSIONS AND ANNUITIES SUMMARY ATTACHMENT CURLENE S TOWNSEND Payer Name Payer's Federal EIN T or S Pension Amount Taxable Amount Capital Gain Incl in Box 2a Federal Tax Withheld Distrib Code IRA/ SEP / SMPL State State Tax Withheld Local Tax Withheld PINELLAS FEDERAL CRE 59-0919852 T FLORIDA RETIREMENT S 59-1354377 T 5,089 25, 602 TOTAL 1099RS 30,691 GEB Form Software Copyright 1996 — 2023 HRB Tax Group, Inc. V0505D 5,089 25, 602 359 7 X 2,345 7 30,691 2,704 FL 22_W2PLO c 2022 FEDERAL TAX WITHHOLDINGS ATTACHMENT CURLENE S TOWNSEND W-2 GOODWILL INDUSTRIES 3,922 1099R PINELLAS FEDERAL CREDIT UN 359 1099R FLORIDA RETIREMENT SYSTEM 2,345 Total to Form 1040/1040 -SR line 25d 6,626 GEB Form Software Copyright 1996— 2023 HRB Tax Group, Inc. V0505D 22_TXFEDWH 2022 SOCIAL SECURITY TAXABLE BENEFITS WORKSHEET CURLENE S TOWNSEND Before you begin: Keep for Your Records Publication 915 ✓ If you are married filing separately and you lived apart from your spouse for all of 2022, enter "D" to the right of the word "benefits" on Form 1040 or 1040 -SR, line 6a. ✓ Don't use this worksheet if you repaid benefits in 2022 and your total repayments (box 4 of Forms SSA -1099 and RRB-1099) were more than your gross benefits for 2022 (box 3 of Forms SSA -1099 and RRB-1099). None of your benefits are taxable for 2022. For more information, see "Repayments More Than Gross Benefits" in Pub 915. ✓ If you are filing Form 8815, Exclusion of Interest From Series EE and I U.S. Savings Bonds Issued After 1989, do not include the amount from line 2b of Form 1040 on line 3 of this worksheet. Instead, include the amount from Schedule B (Form 1040 or 1040 -SR), line 2. 1. Enter the total amount from box 5 of ALL your Forms SSA -1099 and Forms RRB-1099. Also enter this amount on Form 1040 or 1040 -SR, line 6a 1. 17,591 2. Multiply line 1 by 50% (0.50) 2. 8,796 3. Combine the amounts from: Form 1040 or 1040 -SR , lines 1z, 2b, 3b, 4b, 5b, 7, and 8. 3. 57,057 4. Enter the amount, if any, from Form 1040 or 1040 -SR line 2a 4. 5. Enter the total of any exclusions/adjustments for: • Adoption benefits (Form 8839, line 28) • Foreign earned income or housing (Form 2555, lines 45 and 50), and • Certain income of bona fide residents of American Samoa (Form 4563, line 15) or Puerto Rico 5. 6. Combine lines 2, 3, 4, and 5 6. 65,853 7. Form 1040 filers: Enter the amounts from Schedule 1, lines 11 through 20, and 23 and 25 7. 8. Is the amount on line 7 less than the amount on line 6? No. STOP None of your social security benefits are taxable. Enter -0- on Form 1040 or 1040 -SR, line 6b Yes. Subtract line 7 from line 6 8. 65,853 9. If you are: • Married filing jointly, enter $32,000 • Single, head of household, qualifying surviving spouse, or married filing separately and you lived apart from your spouse for all of 2022, enter $25,000 9. 25,000 Note: If you are married filing separately and you lived with your spouse at any time in 2022, skip lines 9 through 16; multiply line 8 by 85% (0.85) and enter the result on line 17. Then go to line 18. Is the amount on line 9 less than the amount on line 8? 10. No. STOP Norte of your benefits are taxable. Enter -0- on Form 1040 or 1040 -SR, line 6b. If you are married filing separately and you lived apart from your spouse for all of 2022, be sure you entered "D" to the right of the word "benefits" on Fm 1040 or 1040 -SR, line 6a. Yes. Subtract line 9 from line 8 10. 40,853 11. Enter: $12,000 if married filing jointly; $9,000 if single, head of household, qualifying surviving spouse, or married filing separately and you lived apart from your spouse for all of 2022 11. 9,000 12. Subtract line 11 from line 10. If zero or less, enter -o- 12. 31,853 13. Enter the smaller of line 10 or line 11 13. 9,000 14. Multiply line 13 by 50% (0.50) 14. 4,500 15. Enter the smaller of line 2 or line 14 15. 4,500 16. Multiply line 12 by 85% (0.85). If line 12 is zero, enter -0- 16. 27,075 17. Add lines 15 and 16 17. 31,575 18. Multiply line 1 by 85% (0.85) 18. 14,952 19. Taxable benefits. Enter the smaller of line 17 or line 18. Also enter this amount on Form 1040 or 1040 -SR line 6b 19. 14,952 TIP: If you received a lump -sum payment in 2022 that was for an earlier year, also complete Worksheet 2 or 3 and Worksheet 4 to see if you can report a lower taxable benefit. GEB Form Software Copyright 1996- 2023 HRB Tax Group, Inc. V0505D 22_SSO ENERGY EFFICIENT HOME IMPROVEMENT CREDIT LIMIT WORKSHEET - LINE 29 CURLENE S TOWNSEND Keep for Your Records Use this worksheet to figure your credit limit. 1. Enter the amount from Form 1040, 1040 -SR, or Form 1040 -NR, line 18 1. 8,229 2. Enter the total of the following credit(s)/adjustment(s) if you are taking the credit(s)/adjustment(s) on your 2022 income tax return: + Negative Form 8978 Adjustment, Schedule 3 (Form 1040), line 61 + Foreign Tax Credit, Schedule 3 (Form 1040), line 1 + Credit for Child and Dependent Care Expenses, Schedule 3 (Form 1040), line 2 + Credit for the Elderly or the Disabled, Schedule R (Form 1040), line 22 + Nonrefundable Education Credits, Schedule 3 (Form 1040), line 3 + Retirement Savings Contributions Credit, Schedule 3 (Form 1040), line 4 Note. Enter the total of the preceding credit(s)/adjustment(s), only if allowed and taken on your 2022 income tax return. Not all credits/adjustments are available for all years nor for all filers. See the instructions for your 2022 income tax return 2. 3• Subtract line 2 from line 1. Also enter this amount on Form 5695, line 29. If zero or less, enter -0- on Form 5695, line 29 and 30 3. 8,229 GEB Form Software Copyright 1996-2023 HRB Tax Group, Inc. R0505B 22_5695CLW 2022 FORM 5695 RESIDENTIAL CLEAN ENERGY CREDIT LIMIT WORKSHEET - LINE 14 CURLENE S TOWNSEND Keep for Your Records 1. Enter the amount from Form 1040, 1040 -SR, or Form 1040 -NR, line 18 1. 8,229 2. Enter the total of the following credit(s)/adjustment(s) if you are taking the credit(s)/adjustment(s) on your 2022 income tax return: + Negative Form 8978 Adjustment, Schedule 3 (Form 1040), line 61 + Foreign Tax Credit, Schedule 3 (Form 1040), line 1 + Credit for Child and Dependent Care Expenses, Schedule 3 (Form 1040), line 2 + Credit for the Elderly or the Disabled, Schedule R (Form 1040), line 22 + Nonrefundable Education Credits, Schedule 3 (Form 1040), line 3 + Retirement Savings Contributions Credit, Schedule 3 (Form 1040), line 4 + Energy efficient home improvement credit, Form 5695, line 30* + Alternative Motor Vehicle Credit, Personal use part, Form 8910, line 15 + Qualified Plug-in Electric Drive Motor Vehicle Credit, Personal use part, Form 8936, Part III, line 23 + Child tax credit and credit for other dependents, Form 1040, 1040 -SR, or 1040 -NR, line 19** + Mortgage Interest Credit, Form 8396, line 9 + Adoption Credit, Form 8839, line 16 + Carryforward of the District of Columbia First -Time Homebuyer Credit, Form 8859, line 3 300 Note. Enter the total of the preceding credit(s)/adjustment(s), only if allowed and taken on your 2022 income tax return. Not all credits/adjustments are available for all years nor for all filers. See the instructions for your 2022 income tax return 2. 300 3. Subtract line 2 from line 1. Also enter this amount on Form 5695, line 14. If zero or less, enter -0- on Form 5695, lines 14 and 15 *If applicable. * *Include the amount from Schedule 8812 (Form 1040), Credit Limit Worksheet B, line 14, instead of the amount from Form 1040, 1040 -SR, or 1040 -NR, line 19, if the instructions for Schedule 8812 (Form 1040) direct you to complete Credit Limit Worksheet B. 3. 7,929 GEB Form Software Copyright 1996— 2023 HRB Tax Group, Inc. R0505B 22_569EPCLW cr 0: 727-444-76501 C: (727) 212-0709 COMMUNTn: REDEVELOPMENT AGENCY From: Dixon, Gregory <gregory.dixon@myclearwater.com> Sent: Friday, February 21, 2025 3:41 PM To: Baltas, Julia <Julia.Baltas@MyClearwater.com> Cc: Shire, Vickie <Vickie.Shire@MyClearwater.com> Subject: Re: Assistance with Property Inquiry: Code Enforcement I only have one case open against the properties on this list. 708 Vine -Outdoor Storage. Not a big deal. Just some plastic bins and some other items being stored on the back porch. Greg Dixon Code Enforcement Inspector City of Clearwater gregory.dixon@myclearwater.com 727-444-8717 Office hours: Mon -Fri 8am-4pm From: Baltas, Julia <Julia.Baltas@MyClearwater.com> Sent: Friday, February 21, 2025 9:13 AM To: Dixon, Gregory <gregory.dixon@myclearwater.com> Cc: Shire, Vickie <Vickie.Shire@ MyClearwater.com> Subject: Assistance with Property Inquiry: Code Enforcement Hello Greg, I hope this email finds you well. I was hoping you could assist me with the properties listed below. Could you please let me know if any of these properties have a code enforcement issue attached to them? 1766 Harbor Dr 1714 Fulton Ave 910 La Salle St 1735 Jade Ave 2 Shire, Vickie From: Edie Minton <EdieM@hepempowers.org> Sent: Monday, October 20, 2025 4:52 PM To: Shire, Vickie Cc: Curlene Townsend Subject: Completed Hours Letter for Curlene Townsend at HEP Attachments: Curlene Townsend Completed Hours Letter at HEP 10.4.2025.docx CAUTION: This email originated from outside of the City of Clearwater. Do not click links or open attachments unless you recognize the sender and know the content is safe. Hi Vickie, Curlene Townsend completed her. teering hours, and I've attached the completed hours letter for Thank you and hope you're having a good day. Grace & Peace, Edie Edie Minton Volunteer Specialist Homeless Empowerment Program (HEP) P: 727.442.9041 ext. 107 C: 727.480.2252 EdieM@HEPempowers.org 1120 North Betty Lane, Clearwater, FL 33755 HEPempowers.org 1 Facebook 1 Instagram Confidential: This electronic message and all contents contain information from HEP, Inc. which may be privileged, confidential or otherwise protected from disclosure. The information is intended to be for the addressee only. If you are not the addressee, any disclosure, copy, distribution or use of the contents of this message is prohibited. If you have received this electronicmessage in error, please notify the sender and destroy the original message and all copies. 1 ADDRESS 727-403-4788 806 Engman St, Clearwater, FL 33755, USA HAPPY'S TREE SERVICE, LLC Serving Pinellas County Clearwater, FL 33755 US 7273651803 happystree@gmail.com http://www.happystreeservice.com Estimate 2740 DATE 09/10/2025 WORK ORDER 'AMOUNT Removal of tree right side of house, hauling all stuff away Disposal Includes all Tree Limbs And Logs. 3% Credit Card Transaction Fee Signing or replying to move forward to this estimate to do the work order is also signing the the attached contract received in your estimate packet. *** This estimate/proposal DOES NOT serve as an assessment of the overall condition or risk of your trees. Trees are living organisms, circumstances and conditions can change rapidly creating an unacceptable or higher risk. Trees with targets of people and or property should be assessed and or monitored by our ISA Certified Arborist Steven Goodell FL -6358A Accepted By SUBTOTAL TAX 2,350.00 0.00 0.00 0.00 2,350.00 0.00 TOTAL $2,350.00 Accepted Date Licensed and Insured For Your Protection All checks must be payable to Happy's Tree Service. All jobs must be paid in full upon completion. We except Checks, Cash, And Credit Cards. AH Checks Payable to Happy's Tree Service. All credit card transactions add 3% convience fee. The price stated above includes all discounts and coupons. JOB ESTIMATE Boutros Construction, LLC 108 Pinckney St. Oldsmar, FL 34677 CBC 1262525 CGC 1532346 TO: Curlene Townsend 806 Engman St. Clearwater, FL 33755 727403-4788 CurlenetownsendPvahoo.com BREAKDOWN OF COST AND SCOPE OF WORK . ,., AMOUNT Driveway Replacement: Removal of exisiting driveway and Installation of 4" concrete driveway with 6" 8,900.00 concrete at apron @ 3,000 PSI with mesh reinforcement. Electrical Panel Replacement: Size for size Repalcement of electrical panel 3,906-94. TOTAL ESTIMATED JOB COST $12,800.00 Mina Boutros PREPARED BY BO I�IROS CONSTRUCTION 2/25/2025 DATE ciutrLwi glRn