CLEARWATER ROOFING CO
I--:tft.,
RetU;"'ltO: (~::-::~r~a7dr sed stamped envelope) .
Name: Merit Title. Inc.
Address:
50 I S. Ft. Harrison, Suite 203
Clearwater. FL 34616
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01 RECO
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DR21
OS
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FEES-
MTF
R~V
WARRANTY DEED.
(FROM CORPORATION)
INST # 97-034192
FEB 6, 1997 4:57PM
mlC()69~1~--S.fW 02-06~1997 16:52:25
01 DED-CITY CLEARWATER
RECORDING 1 $6.00
DOC ST~P - DR219 3 $560.00
--------
$566.00
$566.00
$.00
TOTAL:
CHECK A"T.TENDERED:
CHANGE:
Address:
501 S. Ft. Harrison, Suite 203
Clearwater, FL 34616
This Instrument Prepared by: Merit Title. Inc
Property Appraiser Parcel Identification (Folio) Number(s):
22/29/15/37602/002/0010
PINELLAS COUNTY FLA.
OFF.REC.BK 9602 PG 1115
Grantee(s) S.S.#(s): 59-1549450
~ -<11 \06
SPACE ABOVE TIUS LINE FOR PROCESSING DATA SPACE ABtlVETHISLlJIlE FORllJlCORDING DATA
This Warranty Deed Made and executed the 5th day of February A.D. 1997 by Clearwater Roofing compan;:l
corporation existing under the laws of Florida, and having its principal place of business at 1479 S. Greenwood, Clearwater:J FL I
33516 hereinaftei called the grantor, to CITY OF CLEARWATER, FLORIDA, a Municipal Corporation of the State of Florida
whose post office address is P.O. Box 4748, Clearwater, FL 34618-4748 hereinafter called the grantee:
(Whenever used herein the terms "grantor" and "grantee" include all the parties to this instrument and the heirs.
legal representatives and assigns of individuals, and the successors and assigns of corporations)
Witnesseth: That the grantor, for and in consideration of the sum of $10.00 and other valuable considerations, receipt
whereof is hereby acknowledged, by these presents does grant, bargain, sell, alien, remise, release, convey and confirm unto the
grantee all that certain land situate in Pinellas County, Florida, viz:
Lots 1 through 12 inclusive, Block "B" HARVEY PARK. SUBDIVISION, as recorded in Plat Book 9, Page 94, of the Public
Records of Pinellas County, Florida
Subject To covenants, conditions, restrictions, reservations, limitations, easements and agreements of record, if any;
taxes and assessments for the year 1997 and subsequent years; and to all applicable zoning ordinances and/or restrictions and
prohibitions imposed by governmental authorities, if any,
Together, with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining.
To Have and to Hold, the same in fee simple forever.
And the grantor hereby covenants with said grantee that it is lawfully seized of said land in fee simple; that it has good
right an~LlawfulalJ~hority to sell and convey said land, that it hereby fully warrants the title to said land and will defend the
same a~~!~'#lt la.~~laims of all persons whomsoever; and that said land is free of all encumbrances.
In Witness Whereof, the grantor has caused these
presents to be executed in its name, and its corporate seal
to be hereunto affixed, by its proper officers thereunto
duly authorized, the day and year first above written.
....- .-
(~{)RPOR.ATe)~.) -;:;" :::> "
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ATTEST: . <:> >'
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d delivered in the presence of:
Ro Binder,
Clearwater Roofing
dissolved Corporation
~ ~.
as President of
Company, a
STATE OFFlorida
COUNTY OF PINELLAS
I HEREBY CERlli'Y that on this day, before me, an officer duly authorized in the State and County aforesaid to take
. acknl}wledgnwnts, pcrSGnally appcarcd Rbbert A. ,'Binder---(identifledbydtivers-iicenses,-bc:ing-Uuiy-swornand]-who-didnortake-anoath wen..
known to me to be the President respectively of the corporation named as grantor in the foregoing deed, and that they severally
acknowledged executing the same in the presence of two subscribing witnesses freely volun 'ly under authority duly vested in them by
said corporation and that the seal affixed thereto is the true corporate seal of said corp ation.
WITNESS my hand and official seal in the County and State last aforesai
My Commission Expircs:March 21, 1999
File Number 2971015
6UO.Cfl
Dooumentarv Tllx Pd.
Intanglble Tax Pd.
· F D'."iy" '. i~ellas County
Karl"" . l1eput'( Clerk
Iy - '
(l(J ,i Q n_,
- RD'fu
~~t:&,:,f.~r~.. VIRGINIA A. YOUNGMAN
t., ~.~ MY COMMISSION # CC 446733
.~. . ... EXPIRES ..
"J,';f' "r!".,g,~ : ...arch 21, 1999
..F/."r,i. Bonded Thru Notary Pub!lc UndelWl11ars
--~
Page 1 of1
12-0 ;J,'j_ 1'1/
(ti,)
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d~~~~;~~;POI'iCY
American Land Title Association Owner's Policy 1 Dc 17-92
with Florida modifications
Policy Number SOC 255334
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SUBJECT TO THE EXCLUSIONS FROM COVERAGE, THE EXCEPTIONS FROM COVERAGE CONTAINED
IN SCHEDULE B AND THE CONDITIONS AND STIPULATIONS,
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY, a Minnesota corporation, herein called the
Company, insures, as of Date of Policy shown in Schedule A, against loss or damage, not exceeding the Amount of Insurance stated in Schedule A.
sustained or incurred by the insured by reason of:
1. Title to the estate or interest described in Schedule A being vested other than as stated therein;
2. Any defect in or lien or encumbrance on the title;
3. Unmarketabilityof the title;
4. Lack of a right of access to and from the land.
The Company will also pay the costs, attorneys' fees and expenses incurred in defense of the title,
as insured, but only to the extent provided in the Conditions and Stipulations.
IN WITNESS WHEREOF, the said Old Republic National Title Insurance Company has caused its
corporate name and seal to be hereunder affixed by its duly authorized officers as of the date shown in Schedule A. the policy to be valid when
countersigned by an authorized officer or agent of the Company.
Issued through the Office of:
MERn- 1lTL.E INC.
671 S. Ft. Harri~on, Suite 203
(8 earwater, Flonda 34616
13) 442.9671
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
A Stock Company
400 Second Avenue South. Minneapolis. Minnesota 55401
(612) 311-7 II I
President
By
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Attest
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Old Republic Title Insurance Co.
OWNER'S POLICY
SCHEDULE A
Case Number:
2971015
Amount of Insurance:
$80,000.00
Policy Number:
SDC 255334
Date of Policy:
February 6, 1997 at
4:57pm
THE POLICY NUMBER SHOWN ON THIS SCHEDULE MUST AGREE WITH THE PREPRINTED
NUMBER ON THE COVER SHEET.
1. Name oflnsured:
CITY OF CLEARWATER, FLORIDA, a Municipal Corporation of the State of Florida
2. The estate or interest in the land which is covered by this policy is:
Fee Simple
3. Title to the estate or interest in the land is vested in:
CITY OF CLEARWATER, FLORIDA, a Municipal Corporation of the State of Florida
4. The land referred to in this policy is described as follows:
Lots 1 through 12 inclusive, Block "B" HARVEY PARK SUBDMSION, as recorded in Plat Book 9,
Page 94, of the Public Records of Pine lias County, Florida
ALTA Owner's Policy Form B 1987 (Amended)
This Policy is invalid unless the cover sheet and Schedule B are attached.
Schedule A consists of 1 page(s)
I
.
'.,
I
.
Old Republic Title Insurance Co.
OWNER'S POLICY
SCHEDULE B
Exceptions from Coverage
Date of Policy:
February 6, 1997 at
4:57pm
THE POLICY NUMBER SHOWN ON TIllS SCHEDULE MUST AGREE WITH THE PREPRINTED
NUMBER ON THE COVER SHEET.
Case Number:
2971015
Policy Number:
SDC255334
This policy does not insure against loss or damage (and the Company will not pay costs, attorneys' fees or
expenses) which arise by reason of:
1. Defects, liens, encumbrances, adverse claims or other matters, if any, first appearing in the Public
Records or attaching subsequent to the effective date hereof but prior to the date the proposed insured
acquires for value of record the estate or interest or mortgage thereon covered by this commitment.
2. Facts which would be disclosed by an accurate and comprehensive survey of the premises herein
described.
3. Rights and claims of parties in possession.
4. Construction, mechanics, contractors or materialman's liens and lien claims, if any, where no notice
thereof appears of record.
5. Easements, or claims of easements not shown by the public record.
6. Any and all Special Assesments, Bills, Charges or Minicipal Liens levied and/or assessed against
subject property which are currently due and payable.
7. That certain easement to Florida Power Corporation as recorded in Official Records Book 5444, Page
814, of the Public Records of Pine lias County, Florida.
8. That certain easement as recorded in Official Records Book 5444, Page 816, of the Public Records of
Pinellas County, Florida.
9. That certain easement to the City of Clearwater as recorded in Official Records Book 5444, Page
811, of the Public Records of Pine lias County, Florida.
10. NOTE: Items 1 through 6 are hereby deleted in their entirety.
ALTA Owner's Policy Form B 1987 (Amended)
This Policy is invalid unless the cover sheet and Schedule B are attached.
Schedule B consists of 1 page(s)
.'. ~ .~ ~.. ,,,,,. ." ..~ ._-~-.~:.. ~~-,-
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not be liable for and will not pay the fees oflny other coun~el.' The' .
Company will not pay any fees, costs or expenses incurred by the
insured in the defense of those causes of action which allege matters
not insured against by this policy.
(b) The Company shall have the right, at its own cost, to
institute and prosecute any action or proceeding or to do any other
act which in its opinion may be necessary or desirable to establish
the title to the estate or interest, as insured, or to prevent or reduce
loss or damage to the insured. The Company may take any
appropriate action under the terms of this policy, whether or not it
shall be liable hereunder, and shall not thereby concede liability or
waive any provision of this policy. If the Company shall exercise its
rights under this paragraph, it shall do so diligently.
(c) Whenever the Company shall have brought an action or
interposed a defense as required or permitted by the provisions of
this policy, the Company may pursue any litigation to final
determination by a court of competent jurisdiction and expressly
reserves the right, in its sole discretion, to appeal from any adverse
judgment or order.
(d) In all cases where this policy permits or requires the
Company to prosecute or provide for the defense of any action or
proceeding, the insured shall secure to the Company the right to so
prosecute or provide defense in the action or proceeding, and all
appeals therein, and permit the Company to use, at its option, the
name of the insured for this purpose. Whenever requested by the
Company, the insured, at the Company's expense, shall give the
Company all reasonable aid (i) in any action or proceeding, securing
evidence, obtaining witnesses, prosecuting or defending the action or
proceeding, or effecting settlement, and (ii) in any other lawful act
which in the opinion of the Company may be necessary or desirable
to establish the title to the estate or interest as insured. If the
Company is prejudiced by the failure of the insured to furnish the
required cooperation, the Company's obligations to the insured under
the policy shall terminate, including any liability or obligation to
defend, prosecute, or continue any litigation, with regard to the
matter or matters requiring such cooperation.
5. Proof of Loss or Damage.
In addition to and after the notices required under Section 3 of
these Conditions and Stipulations have been provided the Company, a
proof of loss or damage signed and sworn to by the insured claimant
shall be furnished to the Company within 90 days after the insured
claimant shall ascertain the facts giving rise to the loss or damage.
The proof of loss or damage shall describe the defect in, or lien or
encumbrance on the title, or other matter insured against by this
policy which constitutes the basis of loss or damage and shall state,
to the extent possible, the basis of calculating the amount of the loss
or damage. If the Company is prejudiced by the failure of the insured
claimant to provide the required proof of loss or damage, the
Company's obligations to the insured under the policy shall terminate,
including any liability or obligation to defend, prosecute, or continue
any litigation, with regard to the matter or matters requiring such
proof of loss or damage.
In addition, the insured claimant may reasonably be required to
submit to examination under oath by any authorized representative of
the Company and shall produce for examination, inspection and
copying, at such reasonable times and places as may be designated
by any authorized representative of the Company, all records, books,
ledgers, checks, correspondence and memoranda, whether bearing a
date before or after Date of Policy, which reasonably pertain to the
loss or damage. Further, if requested by any authorized representative
of the Company, the insured claimant shall grant its permission, in
writing, for any authorized representative of the Company to examine,
inspect and copy all records, books, ledgers, checks, correspondence
-;;.;_;;;..,r-.
and memoranda in the cltody or control of a third party, which
reasonably pertain to the~oss or damage. All information designated
as confidential by the insured claimant provided to the Company
pursuant to this Section shall not be disclosed to others unless, in
the reasonable judgment of the Company, it is necessary in the
administration of the claim. Failure of the insured claimant to submit
for examination under oath, produce other reasonably requested
information or grant permission to secure reasonably necessary
information from third parties as required in this paragraph shall
terminate any liability of the Company under this policy as to that
claim.
6. Options to Payor Otherwise Settle Claims: Termination of
Liability
In case of a claim under this policy, the Company shall have the
following additional options:
(a) To Payor Tender Payment of the Amount of Insurance.
To payor tender payment of the amount of insurance under this
policy together with any costs, attorneys' fees and expenses incurred
by the insured claimant, which were authorized by the Company, up to
the time of payment or tender of payment and which the Company is
obligated to pay.
Upon the exercise by the Company of this option, all liability and
obligations to the insured under this policy, other than to make the
payment required, shall terminate, including any liability or obligation
to defend, prosecute, or continue any litigation, and the policy shall
be surrendered to the Company for cancellation.
(b) To Payor Otherwise Settle With Parties Other than the
Insured or With the Insured Claimant.
(i) to payor otherwise settle with other parties for or in
the name of an insured claimant any claim insured against under this
policy, together with any costs, attorneys' fees and expenses incurred
by the insured claimant which were authorized by the Company up to
the time of payment and which the Company is obligated to pay; or
(ii) to payor otherwise settle with the insured claimant
the loss or damage provided for under this policy, together with any
costs, attorneys' fees and expenses incurred by the insured claimant
which were authorized by the Company up to the time of payment
and which the Company is obligated to pay.
Upon the exercise by the Company of either of the options
provided for in paragraphs (b)(i) or (ii), the Company's obligations to
the insured under this policy for the claimed loss or damage, other
than the payments required to be made, shall terminate, including any
liability or obligation to defend, prosecute or continue any litigation.
7. Determination, Extent of Liability
This policy is a contract of indemnity against actual monetary
loss or damage sustained or incurred by the insured claimant who
has suffered loss or damage by reason of matters insured against by
this policy and only to the extent herein described.
(a) The liability of the Company under this policy shall not
exceed the least of:
(i) the Amount of Insurance stated in Schedule A, or,
(ii) the difference between the value of the insured estate
or interest as insured and the value of the insured estate or interest
subject to the defect, lien or encumbrance insured against by this
policy.
(b) The company will pay only those costs, attorneys' fees and
expenses incurred in accordance with Section 4 of the Conditions and
Stipulations.
8. Apportionment.
If the land described in Schedule A consists of two or more
parcels which are not used as a single site, and a loss is established
affecting one or more of the parcels but not all, the loss shall be
computed and settled on a pro rata basis al if the amount of
insurance under this policy was divided pro~ata as to the value on
Date of Policy of each separate parcel to the whole, exclusive of any
improvements made subsequent to Date of Policy, unless a liability or
value has otherwise been agreed upon as to each parcel by the
Company and the insured at the time of the issuance of this policy
and shown by an express statement or by an endorsement attached
to this policy.
9. Limitation of Liability
(a) If the Company establishes the title, or removes the alleged
defect, lien or encumbrance, or cures the lack of a right of access to
or from the land, or cures the claim of unmarketability of title, all as
insured, in a reasonably diligent manner by any method, including
litigation and the completion of any appeals therefrom, it shall have
fully performed its obligations with respect to that matter and shall
not be liable for any loss or damage caused thereby.
(b) In the event of any litigation, including litigation by the
Company or with the Company's consent, the Company shall have no
liability for loss or damage until there has been a final determination
by a court of competent jurisdiction, and disposition of all appeals
therefrom, adverse to the title as insured.
(c) The Company shall not be liable for loss or damage to any
insured for liability voluntarily assumed by the insured in settling any
claim or suit without the prior written consent of the Company.
10. Reduction of Insurance, Reduction or Termination of Liability
All payments under this policy, except payments made for costs,
attorneys' fees and expenses, shall reduce the amount of the
insurance pro tanto.
11. Liability Non-cumulative.
It is expressly understood that the amount of insurance under
this policy shall be reduced by any amount the Company may pay
under any policy insuring a mortgage to which exception is taken in
Schedule B or to which the insured has agreed, assumed, or taken
subject, or which is hereafter executed by an insured and which is a
charge or lien on the estate or interest described or referred to in
Schedule A, and the amount so paid shall be deemed a payment
under this policy to the insured owner.
12. Payment of Loss.
(a) No payment shall be made without producing this policy
for endorsement of the payment unless the policy has been lost or
destroyed, in which case proof of loss or destruction shall be
furnished to the satisfaction of the Company.
(b) When liability and the extent of loss or damage has been
definitely fixed in accordance with these Conditions and Stipulations,
the loss or damage shall be payable within 30 days thereafter.
13. Subrogation Upon Payment or Settlement.
(al The Company's Ri~ht of Subro~ation.
Whenever the Company shall have settled and paid a claim
under this policy, all right of subrogation shall vest in the Company
unaffected by any act of the insured claimant.
The Company shall be subrogated to and be entitled to all
rights and remedies which the insured claimant would have had
against any person or property in respect to the claim had this policy
not been issued. If requested by the Company, the insured claimant
shall transfer to the Company all rights and remedies against any
person or property necessary in order to perfect this right of
subrogation. The insured claimant shall permit the Company to sue,
compromise or settle in the name of the insured claimant and to use
the name of the insured claimant in any transaction or litigation
involving these rights or remedies.
'" 'If a 'payment on ajount of a claim does not fully cover the loss
of the insured claimant, the Company shall be subrogated to-these
rights and remedies in the proportion which the Company's payment
bears to the whole amount of the loss.
If loss should result from any act of the insured claimant, as
stated above, that act shall not void this policy, but the Company, in
that event, shall be required to pay only that part of any losses
insured against by the policy which shall exceed the amount, if any,
lost to the Company by reason of the impairment by the insured
claimant of the Company's right of subrogation.
(b). The Company's Ri~hts Aqainst Non-Insured Obliqors.
The Company's right of subrogation against non-insured obligors
shall exist and shall include, without limitation, the rights of the insured
to indemnities, guaranties, other policies of insurance or bonds,
notwithstanding any terms or conditions contained in those instruments
which provide for subrogation rights by reason of this policy.
14. Arbitration.
Unless prohibited by applicable law. arbitration pursuant to
the Title Insurance Arbitration Rules of the American Arbitration
Association may be demanded if agreed to by both the Company
and the insured. Arbitrable matters may include, but are not
limited to. any controversy or claim between the Company and
the insured arising out of or relating to this policy, any service of
the Company in connection with its issuance or the breach of a
policy provision or other obligation. Arbitration pursuant to this
policy and under the Rules in effect on the date the demand for
arbitration is made or, at the option of the insured, the Rules in
effect at Date of Policy shall be binding upon the parties. The
award may include attorneys' fees only if the laws of the state in
which the land is located permit a court to award attorneys' fees
to a prevailing party. Judgment upon the award rendered by the
Arbitrator{sl may be entered in any court having jurisdiction
thereof.
The law of the situs of the land shall apply to an
arbitration under the Title Insurance Arbitration Rules.
A copy of the Rules may be obtained from the Company
upon request.
15. Liabililty Limited to this Policy; Policy Entire Contract.
(a) This policy together with all endorsements, if any, attached
hereto by the Company is the entire policy and contract between the
insured and the Company. In interpreting any provision of this policy,
this policy shall be construed as a whole.
(bl Any claim of loss or damage, whether or not based on
negligence, and which arises out of the status of the title to the
estate or interest covered hereby or by any action asserting such
claim, shall be restricted to this policy.
(cl No amendment of or endorsement to this policy can be made
except by a writing endorsed hereon or attached hereto signed by either
the President, a Vice President, the Secretary, an Assistant Secretary, or
validating officer or authorized signatory of the Company.
16. Severability.
In the event any provision of the policy is held invalid or
unenforceable under applicable law, the policy shall be deemed not to
include that provision and all other provisions shall remain in full
force and effect.
17. Notices, Where Sent.
All notices required to be given the Company and any statement in
writing required to be furnished the Company shall include the number of
this policy and shall be addressed to the Company at its home office,
400 Second Avenue South, Minneapolis, Minnesota 55401 , (612) 371-1111.
CERTIFIED TO:
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MER~TITLE' INC.
OL PUBLIC NATIONAL TITLE
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LEGEND:
"BOUNDARY SURVEY"
r.t.".. "OUlO .ROIf ROO; ".C.I.".. "0\..11> C~O '"Off "00, !I,C.I."" Sl!T C;AI~(} fflOff "O(J, ".I.~.' 1'0l..l1O IIIOfI rl~1 lnl
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ElF.V.'ELEVATlOffl C.ll.S.. COflcnE'E 8lOCK Slnvcll.f1E1 COIK,'C;O'lCnelEI A5#'tI.' A~IAl..11 r-ylll.. rAYettEIH,
COV,'CQVfIll!(l; 0.. I>!I!Oi SEC.. SfCflOtI: lWf'.. TOYt'tlSl/lP' nOI! . IUJ/(j~i r.. "~TI fl.' IlfASlfl!.O: llt<<-. U.sOIfIH,
n.. nAOll~: A.. MfC, C.' CUOfUJ, C.... Cllano III!AI1"fOI trY. 'SJOftY,c.l." . (IIAltfUII'fJlCf,W.f. . Pt'O<Xlf(Il.:l:
A !lURvey 0,. LOTS 1 THROUGH .lL INCI-iUSIVE BLOCK liB" HARVEY PARK
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AS neCOf1EO It, M..AT 1100/( 9 . "Me '1Jf. Of' Tile "l-.UC neconos OF P't-Il!llA!I eOUITY. nonIOA..
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C. Note:
Settlement Statement 8. Mortgage In.. Ca.e No.
This form is furnished to give you a statement of actual settlement costa. Amounts paid to and by the settlement
agent are shown. Items marked f'POC") were paid outside the cloalng: they are shown here for Information
DurDo.es and are not Included In .the totall.
City of Clearwater, Florida, a Municipal Corporation
Clearwater Roofing Company TIN: 5cr "1'S'~q4 S"O
1. ( ) FHA
4.[ IVA
I. File Number
2971015
.~
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:l B. Type of Loan
2. ( ) FMHA 3. ( ) Conv. Unins.
5. [ I Conv. Ins. [XI Other.
~7. Loan Number
OMS No. 2502-0265
,
A. U.S. Depart t ul Jusing
and Urban Development
D. Name of Borrower:
E. Name of SeUer:
F. Name of Lender:
G. Property Location:
Lot 1-12, Block B, HARVEY PARK
H. Settlement Agent:
Place of Settlement:
I. Settlement Date:
Merit Tille, Inc.
501 S. Ft. Harrison, Suite 203, Clearwater, Florida 34616
215197 ProraUon Date:
TIN: 59-3221111
215197
~!:.r.~~j'_lDltilJ.r'w:~,,:<,..>:,.~~ .
:~i . .<w!~~... .... ...... .":~M:..:..::.. .........i.!Mr.~ :
100. Gross amount due from borrower: 400. GroN lIInOunt due to seller:
101. Contract sales price 80,000.00 401. Contract aaIn DIice
102. Personal pro~ 402. Personal property
103. Settlement charges to borrower (line 1400) 103.50 403.
104. 404.
101. 401.
_ijmt._i~jiiil~'[:ij.tlljii*twmh'~~ .~ Y. ~. . .
108. Cltyltown taxes 401.
107. County taxes 407.
108. Assessments 408.
108. 40..
1~ ~~
111. 411.
112. 412.
120. Gross amount due from borrower: 80,103.50 420. GroN amount due to .eUer: 80,000.00
JH~' ,....:...~. :
201. Deposit or eamest money. &01. Excess deDOII (see Instructions)
202. Principal amount of new loan(s) &02. Settlement ellaroes to l8IIer (Hne1400) 1,248.50
203. Existing loan(s) taken subject to &03. ExiatIrlQ loan a) taken subject to
204. '04. PaYOff of first mongage loan
201. 106. Payoff of HCOnd mortgage loan
208. 108. 1996 Property Taxes (balance)
207. . 107.
208. 608.
208, 10..
iHM_l.iJ~6~)jlir,k ':':~".i.:,.".~l.~~ ~ll~q~~gfM~iltdfWlMltMNtHM:
210. Cityltown taxes 110. Cltyltown taxes
211. County taxes 1/1197 to 215197 145.39 111. County taxes 1/1/97 to 215197 145.39
212. Assessments 612. Assessmenta
213. In.
2K 11~
211. 611.
21~ '1~
21~ '1~
218. 118.
218. .1..
220. Total paid bylfor borrower: 145.39 120. Total reduction In amount due MIler: 82,010.68
:
301. Gross amount due from borrower (line 120) 80,103.50 101. Gross amount due to seller (line 420) 80,000.00
302. Less amount paid by/for borrower (line 220) 145.39 102. L... total reduction In amount due seller(lIne 520) 82,010.68
303. CASH (X)FROM OTO BORROWER 79,958.11 803. CASH (X)FROM OTO SELLER 2,010.88
SUBSTITUTE FORM 1088 SELLER STATEMENT. The information conlalned In Blocks E, G, H and I and on line 401 (or, If line 40118 a8terl8ked, lines 403 and 404) 18 Important
tax Info,malion and 18 belngfurni8hed to the Inlernal Revenue Service. If you are required to file a return, a negllgenca penalty or other sanction will be imposed on you if this item is
required to be reported and the IRS determines that II has not been reported.
SEUER INSTRUCTION .If this real e8tate W118 your principle resldance, liIe form 2118, Sale or Exchange of Principal Residence, for any gain, with your Income tax return; for other
transactions, complete the applicable parts of form 4797, Form 6252 aneIIor Schedule 0 (Form 1040).
You are required by law to prOVide Merit TIUe, Inc. with your correct taxpayer IdentlflC8llon number.
ot provide Merit nc. axpayer identification number, you may be subject 10 civil or criminal penalties.
ber shown on ttQ atatement ~ my correct taxpayer identification number.
80,000.00
Cltyltown taxes
County taxes
Assessments
. ~ .~.:~ .f(-IfiJliij,i~~~Wl$~~@~~~~~~~~~*1*m~~~~~tilit~~~~j!~~j
80,000.00
616.99
,
.'
-~-,..~ . J!:';~Ii:~1~~~~~~~~m~~~i~1~~1~~~~~m~~i~11~~~~~~~1~1i1~M~~~11~~i~@~~~i;~itjijj1;jjji1j11~11~;~tt1~1~f;~jj~
700. Total sales/broker commlssio "i:'~\ Paid From Paid From
Division of commission (line 700 as follows: Borrower's Seller's
701. $ Funds at Funds at
702. $ Settlement Settlement
703. Commission oaid at settlement
704.
".;.q;o... '. , .,
..... ..:::.......... . , .' ....,..... ................ -. ...... .... .... ... .. ,. .. , ,., ...... ., .~ ,
801. Loan orlalnation fee
802. Loan discount
803. AppraJeal fee
804. Credit report
806. Lender's Inspection fee
808. Mortgage Insurance application fee
807. Assumption fee
808.
808.
810.
811.
812.
813.
. .. '. ~ ., .... ":":r: .'. .'.' ..........,...,.., .-
. .... .>~~~~~ ,. :.. . .... .. . . ...... .... '*.... .g. ...
801. Interest from
902. Mortgage Insurance premium for
803. Hazard Insurance premium for
804.
_. ... ...:..... : :... :..::-...:: ...:: . :.. .. ..' ...... . . .. ... ... . .. .... . . . . ... .... ...... .... .....,... ,~l\R:B\
1001. Hazard Insurance
1002. Mortaage Insurance
1003. City property taxes
1004. CounWpropertytaxes
1006. Annual ISsessments (main!.)
1006.
1007.
1008.
1009.
ill ".'''.' ..... ',. . . "~....::.' l_ .m::~*:i~~f.r::1f:.:mOO1~
. 'O:f'&'V. ................
:: .."...~~:~~.:... ;, " . ..... ..... :::~ .. ........ .. .'='*-- .
1101. Settlement or closing fee to Merit Title, Inc. 62,50 62.50
1102. Abstract or title search to Land Research Company POCB 75.00
1103. Title examination to MerIt Title. Inc. 35.00
1104. Title Insurance binder
1106. Document preparation
1106. Notary fees
1107. Attorney's fees to
IncJud.. aboveitema no.:
1108. Title Insurance to Merit Title, Inc. 460.00
Include. above/tema no.:
1108. Lender's coverage
1110. Owner's coverage $80,000.00 $460.00
1111.
1112.
1113.
'~Ii.~\~~\_!'iiii.lif_ir'_" . '.' ..... .Y-/'. .. . w. . . ...w..:~...:....m~~_w:: .~~ilw:ij~im.~!~i~~
~'.. ....~~~::.~~....o;....... . .'. ~ 0; ...~.... .N:.... ...:..... ......... ......... .. ... .. . .' ., ". ." .. ^ .'. , .. .....
1201. Recordina fees: Deed $6.00 Release $6.00 6.00 6.00
1202. City/county tax/stamps:
1203. State tax/stamps: Deed $560.00 560.00
1204~
1206.
1208.
. . ; "~ ~:: '. .' ..... ............... ...... ...
,. .- ..
1301. Survey to Allied SUlVevtna 160.00
1302. Pest In&P8cllon
1303. AppraJsal Review to Sawyer Realty GrouP POCB 500.00
1304. Appraisal to ApmJl8l A8SOCIat.. of Tampa POCB 900.00
1306. Mise to Anthony Hoffmanwelt, Inc. POCB 1000.00
1306. Enalneerlng to Tampa Bay Engineering POCB 1890.00
1400. Total settlement charges (entered on lines 103, section J and 502, section K) 103.50 1,248.50
CERTIFICATION: I have carefully reviewed the HUD-1 Settlement Statement end to my ~e and belief, It ill accu nl of all receiptll
( 1~""~""'~e on my account or by me in t~td.~~.1 furthercartlfylh.~ed~, ~~r . ~r.......... "PR~.
~r _ ~~ _, ~ .
c - r= " -,r; ~ (!;) F--/l~Or"Wo,.p~ "- ~
Borrowers Sellers ,
To the besl of my knowledge, Ihe HUo..1 SeUlement Statement which I have p,epared III a true and accurate account of the funds which were received and have been or will be
disbursed by the underalgned u part of the &eltlement of thistrensacllon.
, .
\~,
1
Settlement Agenl Date
IELLER'I AND/OR PURCHAlIJ\'IITATEMENT iolle(, and Purcha..,., 8lgn&ture hereon ~dlllMl hlIIlheIr apprOVll ofllll proretlona and 81gnlflet their