HARMOND AND VIVIENNE HAYNES
~ (enclose .e~"addres.ed stamped envelope) ~ tJ 'A
Name:.y' I I V'I
. - 910'aOp75 .
! fl!Si U~:" {~t('r;::: ,;,,:: ;.,
Addre.w;
INST t 91-267342
OCT 1.~.u1991, 5J47F'M_____
~'--u'-r-.-.
STEW AtlT n.; _, ,:,
PINELLAS COUNTY FLA.
OFF.REC.BK 7693 PG 1358
l? ikutfL'.fo
This InSITUl1 Il:lnl Prepared by:
Addr...:
-By; .....MIKEL.L__.1.,,;;I~.,,~~IN
1.2);~ L"'J;'i~"~ ~,;: ~
C$.Ct,r1r~';ii;;:;(~ ;::.'L
P.o. Ho~,! 215b
Clri;rWl!h',;ot ]"01; ~"I
\\'hkh ~n"'f,?'nr'j,,;',;." 'J'l' >~4 ~".eP!:lI.;.~ti ~p('iOr'.1 l I.
10 ;,'~l'i~~_~lt~ (:i ~ 'fhk h~su\:uH':' r-'L.:\
37 ~ ()"J
:-... <i (': ' !~.'- r ~. I
Property Appraisers Parcel Identification (Folio) Number(s):
Grantee[s) 5.5. #[s):
SPACE ABOVE THIS LINE FOR PROCESSING DATA
SPACE ABOVE THIS LINE FOR RECORDING DATA
mitis .arrantv IIttil Made the 1st day of October,
HARMOND M. HAYNES and VIVIENNE E. HAYNES, his wife
hereinafter called the grantor, to
CITY OF CLEARWATER, FLORIDA
whose post office address is P.O. BOX 4748, CLEARWATER, FL. 34618
hereinafter called the grantee:
(Whe....ver used he....ln the terms .grantor. and .grant.ee. Include all the parties to this illBl.n1ment and the
heiro, legal rep.....entatlve. and as.lgn. of Individuals, and the Ineeessoro and assignl of eorporations)
.ftnell1lttJy: That the grantor, for and in consideration of the sum of $ 10.00 and other
valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises,
releases, conveys and confirms unto the grantee all that certain land situate in Pinellas
County, State of Florida , viz:
Lot 1, Block "G", HIGHLAND TERRACE MANOR, according to the plat thereof, as
recorded in Plat Book 36, Page 46 of the Public Records of Pinel1as County,
:i \ Florida.
,
! .'
" "1
ce/g
Ro
~
A.D. 19 91
by
parcel number 11/29/15/39258/007/0010
Grantors social sec. lf5fj.-I9-....-II/5' (HARMOND) 3Cff~5',!}-01tJ:3
(VIVIENNE)
mngttIrer. 'LIlith all the tenements, hereditaments and appurtenances tr"ereto belonging or in anywise
appertaining.
mn Jlaue anb tn Jlnlb. the same in fee simple forever.
.Anb the grantor hereby cavenants with said grantee that the grantor is lawfully seized of said land in fee
simple; that the grantor has good right and lawful authority to sell and convey said land, and hereby warrants the
title to said land and will defend the same against the lawful claims of all persons whomsoever; and that sa1:d land
__ is fr~e Of. all encUmb.rances, except ~a:~ii'f~W8&sSu8f<1#g~b;[lmeTn,~~t~))Jtr 'l<f~f easements and
.;un ftnellll Jyerenf. the said grantor has stgned and sealed these presents the day and year first abave
written.
S' ned, sealed and delivered in the presence oj:
u...>J
~ ~~ --f"1c-.<-/(() JY"'",; LL .~ rI I J '11 .u,' Il1D
Signatu.... " <J V
Prin~f:;~NJ) M. HA~~ --A!
/448 () nJ. ct. H, W.o .tiLt CLlfA, 1;: t.3 'Ii / -) .
;'ost <Mi:A.I ......
;J~
,VV0irh~ ~,~
Il1D
Signatun>
Prin~~~ E. HAYNES~, , " . ,
Il/-fmt6 f.::.~/~!J.-f- ~fv a~ ](j{,I"F
Post ee A ......
STATE OF Florida
COUNTY OF Pinellas
I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State aforesaid and in the County aforesaid to take
acknowledgments, personally appeared HARMOND M. HAYNES and VIVIENNE E. HAYNES, his wife
to me known to be the person S described in and
they executed the same,
st of Octobel! ,A,D, 19 91
who executed the f~m!l.wi~),t instrument and they acknowledged before me that
WITNESS--my il/!nd.:oJltid ,official seal in the County and State last afore
.~ ,\. I,.oo!);... ~
":;':<.\~ ~~:..~:~ ~ Co_.: ~. -'
;.:i: ',\~; .~ ~ "v"
'Y;f::;, ," SEAL
" ',"
~
,;.;.
E. S" d/1-1 e'r.s
/1 -::> '-?C/
KARL.EEN F. DEBL.AKER ~;L..FF'I"
RECORD VERIFIED BY: P --i.j'" \ \
- iT" '..'..-..-...... .,..'. .....,..
\
...'
;'. .~,...' ~,"
0" ...J
'..... ...,
; c III /J-~ D
PrinW Notary Sign.tu...
My COnuni~fllion Expil"e~:
ALTA OWNER'S POLICY - (4-6-90) WITH FLORIDA MODIFICATIONS
~\
-it
.. tp; .. ~ :~
"
I
POLICY OF TITLE INSURANCE ISSUED BY
~ ~ ~ ~ ~ ~ ~ ~ -~
91080075
STEWART TITLE
\
t
t
+
t
\
\
t
+
GU ARANTY COMPANY
Company
SUBJECT TO THE EXCLUSIONS FROM C
SCHEDULE B AND THE CONDITIONS AND
corporation, herein called the Company, insures
exceeding the Amount of I nsurance stated in Sc
1. Title to the estate or interest described in
2, Any defect in or lien or encumbrance
3. Unmarketability of the title;
4, Lack of a right of access to and fr9i~
The Company will also pay the costs,.~,
to the extent provided in the Conditions
IN WITNESS WHEREOF, Stewart T
duly authorized officers as of the Date of
RAGE, THE E
PULATIONS, ST
of Date of Polic
Ie A, sustained 0
TIONS FROM COVERAGE CONTAINED IN
ART TITLE GUARANTY COMPANY, a Texas
hown in Schedule A, against loss or damage, not
curred by the insured by reason of:
6ther than as stated therein;
defense of the title, as insured, but only
this policy to be signed and sealed by its
-b~ hr~
~~Ofth':;;~
A'thorized Signatory e
CitY, State
The following matters are expressly excluded from the cove
expenses which arise by reason of:
1, (a) Any law, ordinance or governmental regulation (ind :flQttltnitedfQ,building and zoning laws, ordinances, or regulations) restricting,
regulating, prohibiting or relating to (i) the occupancy, use, or ) the character, dimensions or location of any improvement now or
hereafter erected on the land; (iii) a separation in ownership orn ". ons or area of the land or any parcel of which the land is or was a
part; or (iv) environmental protection, or the effect of any vio of ~e lawtl inances or governmental regulations, except to the extent that a
notice of the enforcement thereof or a notice of a defect, lien or,encumbrance resulting from a violation or alleged violation affecting the land has been
recorded in the public records at Date of Policy,>cJn('lI!) ," (Oil!' a,r
(b) Any governmental police power not excluded by (a) above, except to the extent that a notice of the exercise thereof or a notice of a defect, lien
or encumbrance resulting from a violation or alleged violation aff-ecting the land has been recorded in the public records at Date of Policy.
2, Rights of eminent domain unless notice of the exercise thereof has been recorded in the public records at Date of Policy, but not excluding from
coverage any taking which has occurred prior to Date of Policy which would be binding on the rights of a purchaser for value without knowledge.
3. Defects, liens, encumbrances, adverse claims or other matters:
(a) created, suffered, assumed or agreed to by the insured claimant;
(b) not known to the Company, not recorded in the public records at Date of Policy, but known to the insured claimant and not disclosed in writing to
the Company by the insured claimant prior to the date the insured claimant became an insured under this policy;
(c) resulting in no loss or damage to the insured claimant;
(d) attaching or created subsequent to Date of Policy; or
(e) resulting in loss or damage which would not have been sustained if the insured claimant had paid value for the estate or interest insured by this
policy,
4, Any claim, which arises out of the transaction vesting in the insured the estate or interest insured by this policy, by reason of the operation of
federal bankruptcy, state insolvency, or similar creditors' rights laws,
.......------~-
Page 1 of 0
Policy _ _
Serial No. 2111
15957
~ ~ ~ - ......... -- ~ ~
211 (Rov. 4,6,90)
"
#
,',"
(A:l!IOd S!4~ JO aBed ~sel uo paP"I:lUO:l pue pa"U!~UO:l)
L'paq!JJsap u!aJa4 Iualxa
a41 0'1 '<luC PUD '<)!Icd s!41 .<q IsU!D6D paJnsu! SJall *0' UCsDaJ .<q a6DwDp
JC 550'1 paJaHns sD4 c4M IUDW!DP paJnsu! a41 .<q paJJnJu! JC paU!Dlsns a6D
-WDp JC 550'1 '<JDlaUCW IDnpD IsU!D6D '<1!UWapU! *0' PDJIUCJ D s! .<J!lcd s!41
'AlIll8YI1 ~O 1NiUX~ 'NOI1YNIWnna 'L
'uC!IDb!I!1 AUD anU!IUCJ JC
alnJascJd 'pua*ap 0'1 UC!ID6!1qc JC ~!I!qD!1 .<UD 6u!pnpu! 'aIDU!WJal IID4s 'apDw
aq 0'1 paJ!nbaJ sluaw'<Dd a41 UD41 Ja41C 'a6DwDp JC 550'1 paW!D\J a41 JC* .<J!
-Icd s!41 Japun paJnSU! a41 CISUC!ID6!lqc s,.<uDdwc) a41 '(I!) JC (!)(q s4dDJ6DJDd
U! JC* pap!^cJd sUC!ldc a41 *0' Ja41!a *0' .<uDdwc) a41 .<q as!JJaxa a41 ucdn
'.<Dd 0'1 palD6!1qc s! .<uDdwc) a41 4)!4M PUD luaW.<Dd *0' aW!1 a41 0'1 dn '<uDd
-WC) a41 .<q paZ!JC4InD aJaM 4J!4M IUDW!DP paJnsu! a41 .<q paJJnJu! sasuadxa
PUD saa* ,s'<aUJCIID 'sIsCJ .<UD 41!M Ja41a6cI '.<J!lcd s!41 Japun JC* pap!^cJd a6D
-WDp JC 550'1 a41IUDW!DI) paJnsu! a41 41!M alllas as!MJa4lC JC '<Dd 0'1 (!!)
JC :.<Dd 0'1 palD6!1qc s!
.<uDdwc) a41 4J!4M PUD Iuaw.<od *0' aW!1 a41 0'1 dn .<uDdwc) a41 .<q pazpc41nD
aJaM 4J!4M IUDW!DP paJnsu! a41 .<q paJJnJu! sasuadxa PUD saa* ,s'<aUJCIID 'slsCJ
.<UD 41!M Ja41a6cI '.<J!lcd S!41 Japun IsU!D6D paJnsu! W!DP .<UD IUDW!DP paJnsu!
UD *0' aWDU a41 U! JC JC* sa!IJDd Ja41C 41!M alllas as!MJa41C JC '<Dd 0'1 (!)
'IUDW!DIJ piunsul 8~1 'l1!M
JO p8JnsuI 8'l1 UD'l1 J8'l10 S8!IJDd 'l1!M 81"8S 8S!N\J8'l10 JO ADd 01 (q)
'UC!IDII8JUD)
JC* .<uDdwc) 841 0'1 paJ8pu8JJns aq IID4s .<J!lcd a41 PUD 'uc!ID6!1!1 .<UD
8nU!IUCJ JC 'alnJ8sCJd 'pua*ap 0'1 uC!ID6!lqc JC ~!l!qD!1 .<UD 6u!pnpu! 'aIDU!WJ81
.-fIDIlL'pa.ljnha.qUawADd..a4U~Dw 0'1 UD41 J8~IQ~'<.J!JQ.d..!!Y!..~..'l paJnsUI all! 0'1
suc!IDB!lqc PUD ~!I!qD!I liD 'uc!ldc s!41 *0' .<uDdwc) a41.<q aspJaxa a41 ucdn --.-
'.<Dd 0'1 palD6!1qc s! .<uDdwc) a41 4J!4M PUD luaw.<Dd *0' JapUal
JC IU8W'<Dd *0' aW!1 a41 0'1 dn '.<uDdwc) a41 .<q P8Z!Jc4InD aJaM 4J!4M 'IUDW!DP
p8JnsU! a41 .<q p8JJnJU! sasuadxa PUD S8a* ,s'<aUJCIID '5150') .<UD 41!M J84186CI
.<J!lcd S!41 Japun aJUDJnsU! *0' luncwD a41 *0' luaw.<Dd J8pU81 JC '<Dd 0'1
'8)UDJnsul III Iunowy a'll jO IU8wADd J8pU81 JO ADd 01 (D)
:suc!ldc IDUC!I!PPD
6u!MCllc* a41 a^D4 IID4s .<uDdwc) a41 '.<J!lcd s!41 Japun W!DI) D *0' asDJ ul
'A11118YI1
~O NOI1YNIWBiU ~SWIY1J mns ~SIMB~H10 BO AYd 01 SNOl1dO '9
'W!DP ID41 0'1 SD .<J!lcd s!41 Japun .<uDdwc) a41 *0' ~!l!qD!I .<UD 8IDU!WJ81I1D4s
4dDJ6DJDd s!41 U! paJ!nb8J sD s8!IJDd PJ!41 WCJ* UC!IDWJC*U! '<JDssaJaU '<lqDucs
-DaJ 8JnJ8S 0'1 UC!ss!wJ8d IUDJ6 JC UC!IDWJC*U! palS8nb8J '<lqDucsD8J Ja41C aJnp
-CJd '4IDC Japun UC!IDU!WDXa JC* I!wqns CIIUDW!DP paJnsu! 841 *0' aJnI!D~ 'W!DP
841 *0' UC!IDJls!U!WPD a41 U! ,UDss8JaU s! I! '.<uDdwc) a41 *0' luaw6pn! alqDucSDaJ
a41 U! 'ssalun SJ841C 0'1 P&sCPs!P aq ICU IID4S UC!P8S s!41 CIIUDnsJnd .<uDdwc)
a41 0'1 pap!^cJd IUDW!DP paJnsu! a41 .<q ID!IUap,*UCJ sD palDu6!sap UC!IDWJC*U!
11\1 'a6DWDp JC 550'1 a41 0'1 u!DIJad '<lqDucsDaJ 4)!4M '~JDd PJ!41 D *0' ICJIUCJ JC
ApClsnJ a41 U! DpUDJCWaW PUD aJuapucdsaJJcJ 's~J84J 'sJaepal 's~ccq 'spJcJaJ
liD '<dCJ PUD padsu! 'aU!WDXa 0'1 .<uDdwc) a41 *0' a^!IDIUasaJdaJ paZIJC41nD
AUD JC* '6U!I!JM U! 'UC!ss!wJad 51! IUDJ6 IID4s IUDW!DIJ paJnsu! a41 '.<uDdwc) a41
*0' a^!IDIUasaJdaJ paZ!JC4InD .<UD .<q palsanbaJ *! 'Ja4pn~ 'a6DwDp Jc sscl a41 0'1
u!Dpad '<lqDucsDaJ 4J!4M ''<J!lcd *0' alDO Jal*D JC aJc*aq alDp D 6U!JDaq Ja41a4M
'DpUDJCWaW PUD aJuapucdsaJJcJ 'S~Ja4J'sJa6pal 's~ccq 'spJcJaJ liD '.<uDd
-WC) a41 *0' a^!IDIU8SaJdaJ pazpc41nD .<UD .<q palDU6!sap 8q '<DW SD saJDld PUD
saW!1 alqDucsDaJ 4Jns ID '6u!'<dc) PUD uc!padsu! 'UC!IDU!WDXa JC* aJnpcJd IID4s
PUD .<uDdwc) a41 *0' a^!IDIU8saJdaJ paZ!JC4InD .<UD .<q 41DC Japun UC!IDU!WDXa
CII!wqns 0'1 paJ!nbaJ aq '<,qDucsDaJ '<DW IUDW!DP paJnsu! a41 'UC!I!PpD UI
'aBDwDp
-JO 5501 *c-*oold Qjh56Up!nbanJautYw ro ,8IlDW;;ljl 0'1 pro&J'411M-'UO)ID6!I!I-AUD-'
anU!luCJ JC '8lnJascJd 'pua*ap 0'1 uC!ID6!1qc JC '<1!I!qD!1 .<UD 6u!pnpu! 'aIDU!WJal
IID4s .<J!lcd a41 Japun paJnsu! a41 0'1 suc!ID6!lqc s,'<uDdwc) a41 'a6DwDp JC 550'1
*0' *cCJd paJ!nbaJ a41 ap!^cJd CIIUDW!DP paJnsu! a41 *0' aJnl!D* a41 .<q paJ!pn!aJd
S! .<uDdwc) a41 H 'a6DWDp JC 550'1 a41 *0' luncwD a41 6u!!DlnJIDJ *0' s!sDq a41 'alq
-!sscd Iualxa a41 0'1 'alDls IID4s PUD a6DwDp JC 550'1 *0' s!sDq a41 s8Inl!ISUCJ 4J!4M
.<J!lcd s!41 .<q ISU!D6D paJnSU! JallDW Ja41C JC 'all!1 a41 uc aJUDJqwnJUa JC ua!l JC
'U! pa*ap a41 aq!map IID4S a6DWDp Jc 550'1 *0' *cCJd a41 'a6DWDp Jc SSCI a41 0'1
as!J 6u!^!6 sPD* a41 U!DlJa)sD IID4S IUDW!DIJ paJnsu! a41 Jal*D s'<DP 06 U!41!M '<uDd
-WC) a41 0'1 pa4s!uJn* aq IID4s IUDW!DP paJnsu! a41.<q 0'1 UJCMs PUD pau6!s a6D
'WDP JC 550'1 *0' *cCJd D '.<uDdwc) a41 pap!^cJd uaaq a^D4 suc!IDlnd!IS PUD SUC!1
'!PUC) asa41 *0' 8 uc!pas Japun paJ!nbaJ SaJ!ICU a41 JaHD PUD 0'1 UC!I!PPD UI
'~~YWYa BO SS01 ~O ~OOBd '~
'UC!IDJadccJ 4Jns 6u!J!nbaJ sJallDW JC JallDW a41 0'1 pJD6aJ 41!M 'UC!ID6!1!I
.<UD anU!IUCJ JC 'alnJascJd 'pua*ap 0'1 uC!ID6!1qc JC '<I!I!qD!I .<UD 6u!pnl)U! 'aIDU!W
-Ja11lD4s .<J!lcd a41 Japun paJnsu! a41 0'1 suc!ID6!lqc s,.<uDdwc) a41 'UC!IDJadccJ
paJ!nbaJ a41 4s!uJn* 0'1 paJnsu! a41 *0' aJnl!D* a41 .<q paJ!pn!aJd s! .<uDdwc) a41 H
'paJnsu! sD IsaJalU! JC alDlsa a41 0'1 all!1 a41 4S!lqDlsa 0'1 alqDJ!sap JC '<JDssaJaU aq
,(DW .<uDdwc) a41 *0' uc!u!dc a41 U! 4J!4M pD In*MDI Ja41C .<UD U! (!!) PUD 'Iuaw
-alllas 6u!paHa JC '6u!paaJcJd JC UC!PD a41 6u!pua*ap JC 6u!lnJascJd 'sassau
-I!M 6U!U!Dlqc 'aJuap!^a 6u!Jn)as '6u!paaJcJd JC UC!PD .<UD U! (!) P!D alqDucsDaJ
liD .<uDdwc) a41 a^!6 IID4s 'asuadxa s,.<uDdwc) a41 ID 'paJnsu! a41 '.<uDdwc)
841 .<q palsanbaJ Ja^aua4M 'ascdJnd S!41 Jc* paJnsu! a41 *0' aWDU a41 'UC!ldc
51! ID 'asn 0'1 .<uDdwc) a411!WJad PUD 'U!aJa41 slDaddD liD PUD '6u!paaJcJd JC
UC!PD a41 U! asua*ap ap!^cJd JC alnJascJd 0'5 C1146!J a41 .<uDdwc) a41 0'1 aJnJas
IID4s/aJnSU! a41 '6u!paaJcJd JC UC!PD .<UD *0' asua*ap a41 JC* ap!^cJd JC alnJ
-aSCJ 0'1 .<uDdwc) a41 saJ!nbaJ JC sl!WJad .<J!lcd S!41 aJa4M saSDJ liD UI (p)
I 'Jap;c JC luaw6pn! as~~^~D
.<UD WCJ* IDaddD 0'1 'UC!laJ)s!p alcs SI! U! '146!J a41 sa^JasaJ '<lssaJdxa PUD UC!I
,)!ps!Jn! lualadwcJ *0' IJnCJ D .<q UC!IDU!WJalap IDu,* 0'1 UC!ID6!1!I .<UD ansJnd '<DW
.<uDdwc) a41 '.<J!lcd S!41 *0' sUC!s!^cJd a41 .<q pall!wJad JC paJ!nbaJ sD asua*ap
D pasCdJalU! Jc UC!PD UD 146ncJq a^D4 IID4s .<uDdwc) a41 Ja^au84M ())
''<llua6!1!p
cs cp IID4s I! '4dDJ6DJDd S!41 Japun s146!J SI! as!)J8Xa IID4s .<uDdwc) a41 H ''<)!Icd
s!41 *0' UC!s!^cJd .<UD a^!DM JC ~!l!qD!1 apaJucJ '<qaJa411CU IID4s PUD 'JapUn8J84
alqD!I aq 11045 I! ICU JC Ja4184M '.<J!lcd s!41 *0' sWJal a41 Japun UC!PD alo!JdcJddo
.<UD a~ol ,(ow .<uodwc) a41 'paJnsu! a41 0'1 a60wDp JC 550'1 aJnp8J JC lua^aJd 0'1
JC 'paJnSU! 50 'lsaJalU! JC alOlsa a41 0'1 all!1 a41 4S!lqDlsa 0'1 alqOJ!S8P JC '<JDssaJaU
aq '<DW uc!u!dc 51! U! 4J!4M pD Ja41C .<UD cp 0'1 JC 6u!paaJcJd JC UC!PO .<uo alnJ
-ascJd PUD alnl!lsU! 0'1 'lsCJ UMC 51! ID '146!J a41 a^04 11045 .<uDdwc) a41 (q)
'AJ!ICd s!41
.<q ISU!D6D paJnsu! ICU sJallDW a6allD 4J!4M UC!PD *0' sasnDJ asc41 *0' asua*ap a41
U! P8JnsU! a41 .<q P8JJnJU! sasuadxa JC sIsCJ 'saa* ,(UD .<od ICU II!M .<uodwc) a41
'lasuncJ J841C .<UD *0' saa* a41 .<od ICU II!M PUD JC* alqo!, aq ICU 11045 PUD UC!PO
*0' sasnOJ palDls asc41 0'1 sD paJnsu! a411UaSaJdaJ 0'1 asnOJ alqoucsoaJ JC* pa!qc
0'1 p8JnSU! a41 *0' 146!J a41 0'1 pa!qns) aJ!C4J 51! *0' lasunoJ P818S C1146!J 841 a^04
II04s .<uDdwc) a41 '.<J!lcd s!41 .<q Isu!D60 paJnsu! JallDW Ja41C JC aJuoJqwnJU8
JC ua!l 'pa*ap D 6u!6allO UC!PD *0' sasnDJ palOls asc41 0'1 50 '<IUC Inq 'p8JnsU!
50 IsaJalU! JC all!1 a41 0'1 aSJa^pD W!OP 0 slJaSSD 410d PJ!41'<UO 4J!4M U! UC!ID6!1!I
U! paJnsu! UD *0' asua*ap 841 JC* ap!^cJd 11045 '.<olap alqoucsoaJun Inc41!M puo
IsCJUMC 51! 10 '.<uDdwc) a4I'sUC!10Ind!IS pUO sUC!I!PUC) asa41 *0' 9 UC!P8S U!
-'paU!DIUOJ su'c!~do a4r 0'1 ~Ja!qns pUD F.I1'I5Uraljl ,(qlsanbanrall!JMucdn(o)
'iUn~dOOJ 011NYWIY1J
annSNI ~O AJ.na ~SNOIlJY ~O NOllnJ~SOBd aNY ~SN~~~a '~
'aJ!pn!aJd a41 *0' IU91xa a41 0'1 '<luC ua41 puo 8Jnl!0*a41 Aq p8)!pn!8Jd
8q 11045 .<uodwc) 841 ssalun .<J!lcd s!41 Japun paJnsu! .<uo *0' s146!J 841 aJ!pn!aJd
8s0J cu U! 11045 .<uodwc) a41'<*!ICU 0'1 aJnl!o* 1041'Ja^aMc4 'P8p!^cJd :paJ!nbaJ
s! aJ!ICU IdwCJd 4J!4M JC* sJ8110W JC JallOW a41 0'1 pJ06aJ 41!M aIOU!WJal 11045
.<uodwc) a41 *0' ~!I!qo!l liD paJnsu! 841 0'150 ua41 '.<uodwc) a41 0'1 U8^!6 aq ICU
IID4S aJ!ICU IdWCJd H 'alqola~Jowun sD papa!aJ s! 'paJnSU! 50 'lsaJaIU! JC alDlsa
841 0'1 all!1 H (!!!) JC '.<J!lcd s!41 *0' anp!^ .<q alqo!l aq .<ow .<uodwc) 841 4J!4M
JC* a60wop JC 550'1 8snDJ 146!W 4J!4M pUO 'paJnsu! sD 'ls8J8IU! JC alOlsa a41 0'1
all!1 a41 0'1 asJa^pD s! 4J!4M IsaJalU! JC all!! *0' W!OP .<UD *0' JapunaJa4 paJnsu! UO
0'1 aWCJ 11045 a6palMcu~ asDJ U! (!!) 'Mclaq (D)~ uc!pas U! 41Jc* las 50 UC!ID6!1!1 .
.<UO *0' asDJ U! (!) 6U!IPM U! '<lldWCJd .<uDdwc) a41 '<HICU IID4S paJnsu! 841
'1NYWI\f1J a~BnSNI A8 N~^I~ ~8 01 WIY1J ~O ~JIlON '8
'paJnsu! a41 0'1 ua^!6 a606IJcw ~aucw as04)Jncf 0 Aq paJnJ8s sS8Up8Iq8PU! uo
(!!) JC 'puDI a41 U! IsaJ8IU! JC alDlsa uo (!) Ja41!a *0' paJnsu! a41 WCJ* Jas04)Jnd .<uo
*0' JC^o* U! aJJc* U! anU!IUCJ ICU 11045 .<J!lcd S!4J. 'lsaJalU! JC al0ls8 a41 *0' 8JUO
-.<a^ucJ JC Ja*sUOJI .<uo U! paJnsu! a41 .<q apDw ~UOJJOM *0' sIUOUa^cJ *0' UCs08J
.<q ~!I!qo!l a^04 IID4s paJnsu! a41 50 6uCI 0'5 .<'UC JC 'paJnsu! a41 WCJ* J8s04JJnd 0
.<q ua^!6 a606IJcw .<aucw aS04)Jnd D .<q paJn)8s ssaupalq8PU! uo SPIC4 JC 'PUDI
a41 U! IsaJalU! JC alDlsa UD sU!OlaJ paJnSU! a41 sD 6uCI cs '<IUC paJnSU! UD *0' JC^O*
U! '<J!lCd *0' alDO *0' sD aJJc* U! anU!IUCJ IID4s .<J!lcd s!41 *0' a60Ja^cJ a41
'mll ~O ~JNY A3^NOJ B~HY ~JNYBnSNI ~O NOIJ.ynNIlNOJ 'l
'all!1 alqDla~Jow *0' AJa^!Iap
a41 6u!J!nbaJ UC!I!PUCJ 10npDJIUCJ D *0' anp!^ .<q as04JJnd 0'1 uC!106!lqc a41
WCJ* pasoalaJ aq 0'1 \I alnpa4)S U! paq!map IsaJalU! JC alDlsa a41 fC Jas04JJnd 0
all!IUa PlncM 4J!4M 'a60Ja^cJ WCJ* paldaJxa JC papnpxa ICU 'puol a41 0'1 all!1 a41
6u!paHD JallDW luaJoddD JC pa6all0 UD :"all!1 a41 *0' '<I!I!qola~JOWUn" (6)
. -- .-. "- ,'-'paIDJcls!,puoI.a414J!4M U!P1JIS!pa41-Jc* pnQJ P!Jj5!P-
salDIS pal!Un a41 *0' ~Jap a41 *0' spJcJaJ a41 U! pal!* sua!l UC!paICJd 10IUaWUCJ!^ua
apnlJu! 0'510 11045 "spJcJaJ J!lqnd" 'a6DJa^C) WCJ~ suc!snlJx3 a41 *0' (^!)(Dh
uc!pas 0'1 padsaJ 41!M 'a6palMcu~ Ino41!M PUD anlo^ JC* sJas04JJnd 0'1 '<lJadcJd
IDaJ 0'1 6u!101aJ sJallDW *0' aJ!ICU a^!pnJlsUCJ 6u!podw! *0' ascdJnd a41 JC* .<J!
-Icd *0' alDO ID salnlols alols Japun pa4s!lqDlsa spJcJaJ :"spJcJaJ J!lqnd" (*)
'IUaWnJlsUI
~!JnJas Ja41C JC 'paap IsnJI 'lsnJI *0' paap 'a6D6pcw :, a6D6IJcw)\ (a) ,
,XJ!lcd s!41 ^q paJnsu!
S! puol a41 WCJ* PUD 0'1 ssaDD *0' 146!J D 4J!4M 0'1 Iualxa a41 I!W!I JO' '<HpcW
IID4s u!aJa4 6u!41cu Inq 's'<oMJaIDM JC s.<OM 'sauDI 's.<aIlD 'sanUa^D 'spDCJ 'SlaaJls
6U!lInqD U! luawaSDa JC alDlsa 'ISaJaIU! 'all!1 '146!J .<UD JCU '\I alnpa4JS U! 0'1
paJJa*aJ JC paq!map DaJD a41 *0' sau!I a41 puc.<aq 41adcJd .<UO apnpu! ICU sacp
"PUDI \ WJal a41 ''<padcJd IDaJ alnl!lsUCJ MOl .<q 4)!4M claJa41 pax!Ho sluaw
.a^O'Jdw! PUD '\I alnpa4JS U! 0'1 paJJa*aJ JC paq!map pUDI a41 :"puol" (p)
'puDI a41 6u!paHo sJallow
*0' aJ!ICU a^!pnJlsUCJ pDdw! 4J!4M spJcJaJ Ja41C .<UD JC '<)!Icd s!41 U! pau,*ap
sD spJcJaJ J!lqnd a41 *0' UCsDaJ .<q paJnsu! UD 0'1 palndw! aq ,(DW 4J!4M aJ!ICU JC
a6palMcu~ a^!pnJlsUCJ ICU 'a6paIMcu~ 10npD :"UMO'U~" JO' "a6paIMcu~" ())
'a6DwDp JC sscl 6u!W!DIJ paJnsu! UD :"IUDW!DP paJnsu!" (q)
'SJcssaJJns '<JDpnp,* JC alDJO'dJcJ JC 'U!~ *0' Ixau 'sa^!IDIUasaJdaJ 10ucsJad
'sJc^!^Jns 'saas!^ap 'saalnq!Jls!P 'sJ!a4 '0'1 pal!W!r ICU Inq '6u!pnIJU! as04JJnd WCJ*
pa4s!n6u!ls!P sD MDI *0' UC!IDJadc .<q paJnsu! pawDu a411O' IsaJalU! a41 0'1 paaDns
O'4M asc41 'paJnsu! pawDu a411sU!D6D PD4 a^D4 PlncM uodwc) a41 sasua*ap JC
s146!J .<UD 0'1 pa!qns 'pUD '\I alnpa4JS U! pawDu paJnslI! a41 :"paJnsu!" (D)
:UDaw ,{J!lcd S!41 U! pasn ua4M sWJal 6u!MCllc* a41
'SWBiU ~O NOIlINI~~a 'I
SNOlmndllS aNY SNOlllaNOJ
AL'fA OWNER'S POLICY
'. .
mls
I
I
15957
SCHEDULE A
Order No,:
October 01, 1991
Policy No,:
0-2111-
Amount of Insurance: $
15957
91080075
Date of Policy:
65,000.00
1, Name of Insured:
CITY OF CLEARWATER, 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
4, The land referred to in this policy is described as follows:
Lot 1, Block "G", HIGHLAND TERRACE MANOR, according to the Plat
thereof, as recorded in Plat Book 36, Page 46 of the Public
Records of PINELLAS County, Florida.
REG. 0 0012
Page 2
STEWART TITI..I~
GUARANTY COMPANY
AL TA OWNER'S POLICY
Order No. 91080075
'.
I
SCHEDULE B
I
Policy No,:
2111
0~-15957
This policy does not insure against loss or damage by reason of the following:
delete 1, fN~
delete 2. E h
3, Encroachments, overlaps, boundary line disputes, or other matters which would be disclosed by
an accurate survey and inspection of the premises.
delete
4.A~
d,
delete 5,
t~
~
~~.
of
delete
6,
~
7, Taxes for the year 19 92 ~ and thereafter.
'8. Restrictive Covenants appearing in Deed Book 1533, Page 94 of
the Public Records of PINELLAS County, Florida.
~ 9. Subject to easement twenty-five (25) feet wide over and across
the southerly boundary line for unknown usage as shown on plat
recorded in Plat Book 36, Page 46 of the Public Records of
PINELLAS County, Florida.
-10. Subject to easement eight (8) feet wide over and across the
westerly boundary line for unknown usage as shown on plat
recorded in Plat Book 36, Page 46 of the Public Records of
PINELLAS County, Florida.
11. Subject to facts of survey by EVANS LAND SURVEYING, dated August
22, 1991 showing the CONCRETE HEADWALL encroaching into the
twenty five (25) foot easement over the southerly boundary; the
CONCRETE HEADWALL encroaching into the eight (8) foot easement
over the westerly boundary; and the STORM SEWER JUNCTION BOX
encroaching into Lot 1 and into adjacent Lot 2 from the eight
(8) foot easement.
2113
Page 3
STEWART TITLE
GUARANTY COMPANY
----------;;--;--:---c--...-,,,,,",
, . oJ
.-
J>NDITIONS AND STIPULATIONS Continued I
(continued and concluded from reverse side of Policy Face)
(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.
iliJ (This paragraph removed in Florida policies.)
(c) The Company will pay only those costs, attorneys' fees and expenses
incurred in accor~ance 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
p,arcels but not all, the loss shall be computed and settled on a pro rata basis as
If the amount of insurance under this policy was divided pro rata 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.
AIl/ayments under this policy, except payments made for costs, attorneys'
fees an expenses, shall reduce the amount of the insurance pro tanto.
11. LIABILITY NONCUMULATIVE.
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 8 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 endorse-
ment of the payment unless the policy has been lost or destroyed, in which case
proof of loss or destruction shall be furnished to the sa~sfaction 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.
(a) The Company's Right of Subrogation.
Whenever the Company shall have settled and paid a claim under this pol-
icy, 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 reme.
dies 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 Com-
pany, 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 subro-
gation, The insured claimant shal! 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 account 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 tOlay only that part of any losses insured against by this policy which
shall excee the amount, if any, lost to the Company by reason of the impair-
ment by the insured claimant of the Company's right of subrogation,
(b) The Company's Rights Against Non-insured Obligors.
The Company's right of subrogation against non-insured obligors shall exist
and shall include, without limitation, the rights of the insured to indemnities, gua-
ranties, other policies of insurance or bonds, notwithstanding any terms or condi-
tions contained in those instruments which provide for subrogation rights by rea-
son of this policy: ,
14. ARBITRATION
Unless prohibited by applicable law, arbitration pursuant to the Title Insur:
once 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/s) may be entered in any court
having iurisdiction 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. LIABILITY 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 Com-
pany. In interpreting any provision of this policy, this policy shall be construed as
a whole,
(b) 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,
(c) 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 rolicy shall be deemed not to include that provision and all
other provisions shal 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 P.O. Box 2029, Houston, Texas 77252.
STEWART TITLE
GUARANTY COMPANY
. ..- .." '"
",;,
::r:
o
c
'" "
go
. .
-IlXl
(1) 0
X X
e: I\,)
o
'-II\,)
'-Ice
I\,)
U1
I\,)
rJ1
~
Q~
~~
~>
~~
g~
~~
i"-~
=~
~
~
~\
en
)>
'TI
m
-I
-<
"Tl:O
om
CJ'l :0(')
o
~ ~G)
O Oz
:0-
Z)>mN )>
-<cn~m Z
~CJIO
O~)>Z )>
CZZ)> ~
CJ'l G) -l m
~ ~O
=i -<Z
I m)>
)>r
:or
cn-<
rJ1
~
Q~
~~
~>
~~
g~
~~
~~
~~
~
~
z
(")
o
:0
"tI
o
:0
)>
~
m
o
m
CJ'l
~
)>
CD
r
CJ'l
I
m
o
-'
OJ
co
(j)
-'
co
o
OJ
YJ
~
~.
',<
,0
'"
!"'\
~'
~
.,
~
-c;
I
;,':)
-- --- .. - ~
1
1'/
-- -- -- - -- -- -- -- --v.
-
Z
en-l "'a
c:_ 0
:z:J-IOr-
)>r-T1(5
Zm -<
o
m
1
.'/
I
I
CITY OF CLEARWATER
Interdepartmental Correspondence Sheet
FROM:
Cynthia E. Goudeau, City Clerk
M. A. Galbraith, Jr., city Attorney ~
Purchase from Harmond M. and Vivienne E. Haynes - Lot 1,
Block G, Highland Terrace Manor - For storm water
management
TO:
RE:
DATE:
October 1, 1991
The subj ect purchase was completed today, and enclosed are the
following documents:
Contract for Purchase and Sale
Settlement Statement
Title Commitment # C-9912-762539 issued by Stewart Title
Guaranty Company
Copy of warranty deed
Survey
copies of:
Non-foreign certification by individual transferor
Indemnity and affidavit
Disclosure
Information for real estate 1099-S report filing
Authorization and acknowledgement form
I will forward the original deed and title policy when I receive
them.
MAG: jmp
Enclosures
Copy:
Daniel J. Deignan, Finance Director wjcopy of Settlement Statement
RECEIVED
OCT 0 2 1991
CITY CLERK
CONTRACT FOR SALE AND PURCHASE
:;RTIES: Harmond M. c;nd Vivient E. Haunesl (Phone ("seller";:
and C i t Y 0 f C lea r w ate r, f lor 1. d a ("Buyer"),
of P.O. Box 4-74-8, Clearwater, florida, 34-618 (Phone ),
hereby agree that the Seller shall sell and Buyer shall buy the following real property ("Real Property") and personal property ("Personalty") (collectively "Property") upon the following
terms and conditions, which INCLUDE the Standards for Real Estate Transactions ("Standard(s)") printed on the reverse or attached and any Riders and Addenda to this instrument.
I. DESCRIPTION:
(a) Legal description of Real Property located in Pin e l 1 a s
Highland Terrace Manor, Blk G, Lot 1
County, Florida:
(b) Street address, city, zip, of the Property is:
(c) Personalty:
1314- N. Highland Ave. Clearwa~er, Florida 34-615
II.
PURCHASE PRICE. ...,. ... ., " .,.."......,. .. .. .. ,.. .. ... ...... .... ..,.,
PAYMENT:
(a) Deposit(s) to be held in escrow by in the amount of .. $
(b) Additional escrow deposit within days after Effective Date in the amount of .......................... ...............,......... $
(c) Subject to AND assumption of mortgage in good standing in favor of
.... $
65,000.00
-0
....0
having an approximate present principal balance of , . $
(d) Purchase money mortgage and note bearing annual interest at % (see Addendum) in amount of ... ...."."",."."."."""" $
(e) Other: $
(f) Balance to close (U.S, cash, LOCALLY DRAWN certified or cashier's check), subject to adjustments and prorations....,..,...."..,.......... $
III. TIME FOR ACCEPTANCE; EFFECTIVE' DATE; FACSIMILE: If this offer is not executed by and delivered to all parties OR FACT OF EXECUTION communicated in writing
between the parties on or before 9 - 5 - 9 1 , the deposit(s) will, at Buyer's option, be returned to Buyer and this offer withdrawn. A facsimile copy of this
Contract for Sale and Purchase ("Contract") and any signatures hereon shall be considered for all purposes as originals. The date of Contract ("Effective Date") will be the date when
the last one of the Buyer and Seller has signed this offer,
IV. FINANCING: N. A .
-0
-0
()
65,000.00
(a) If the purchase price or anY..Eart of it is to be financed by a third-party loan, this Contract is conditioned on the Buyer obtaining a written commitment for (CHECK (1)
or (2) or (3)): (1) D a fixed, (2) U an adjustable or (3) D a fixed or adjustable rate loan within~ days after Effective Date at an initial interest rate not to exceed~ %,
term of It a years and for the principal amount of $ n a , Buyer will make application within n a days after Effective Date and use reasonable
diligence to obtain the loan commitment and, thereafter, to meet the terms and conditions of the commitment and close the loan. Buyer shall pay all loan expenses. If Buyer
fails to obtain the commitment or fails to waive Buyer's rights under this subparagraph within the time for obtaining the commitment or after diligent effort fails to meet the
terms and conditions of the commitment, then either party thereafter by prompt written notice to the other may cancel the Contract and Buyer shall be refunded the deposit(s),
(b) The existing mortgage described in Paragraph lI(c) above has (CHECK (1) or (2)): (1) D a variable interest rate or (2) D a fixed interest rate of n a % per annum,
At time of title transfer some fixed interest rates are subject to increase, If increased, the rate shall not exceed n a % per annum. Seller shall, within n a days after
Effective Date, furnish statements from all mortgagees stating principal balances, method of payment, interest rate and status of mortgages, If Buyer has agreed to assume a
mortgage which requires approval of Buyer by the mortgagee for assurwtion, then Buyer shall promptly obtain ~II required applications and will diligently complete and return
them to the mortgagee. Any mortgagee charge(s) not to exceed $ a shall be paid by a (if not filled in, equally divided). If Buyer is not
accepted by mortgagee or the requirements for assumption are not in accordance with the terms of this Contract or mortgagee makes a charge in excess of the stated amount,
Seller or Buyer may rescind this Contract by prompt written notice to the other party unless either elects to pay the increase in interest rate or excess mortgagee charges.
V. TITLE EVIDENCE: At least 5 days before closing date, Seller shall, at Seller's expense, deliver to Buyer or Buyer's attorney, in accordance with Standard A,
(CHECK (1) or (2)): (1) D abstract of title or (2~title insurance commitment and, after closing, owner's policy of title insurance.
VI. CLOSING DATE: This transaction shall be closed and the deed and other closing papers delivered on 1 0 0 1 9 1 , unless extended by other provisions of Contract.
VII. RESTRICTIONS; EASEMENTS; LIMITATIONS: Buyer shall take title subject to; zoning, restrictions, prohibitions and other requirements imposed by governmental authority; restrictions
and matters appearing on the plat or otherwise common to the subdivision; public utility easements of record (easements are to be located contiguous to Real Property lines and
not more than 10 feet in width as to the rear or front lines and 71/2 feet in width as to the side lines, unless otherwise stated herein); taxes for year of closing and subsequent
, , of record
years; assumed mortgages and purchase money mortgages, If any; other:
; provided,
that there exists at closing no violation of the foregoing and none of them prevents use of Real Property for n a purpose(s).
VIII. OCCUPANCY: Seller warrants that there are no parties in occupancy other than Seller; but, if Property is intended to be rented or occupied beyond closing, the fact and terms
thereof shall be stated herein and the tenant(s) or occupants disclosed pursuant to Standard F, Seller agrees to deliver occupancy of Property at time of closing unless otherwise
stated herein. If occupancy is to be delivered before closing, Buyer assumes all risk of loss to Property from date of occupancy, shall be responsible and liable for maintenance from
that date, and shall be deemed to have accepted Property in its existing condition as of time of taking occupancy unless otherwise stated herein or in a separate writing,
IX. TYPEWRITTEN OR HANDWRITTEN PROVISIONS: Typewritten or handwritten provisions shall control all printed provisions of Contract in conflict with them.
X. RIDERS: (CHECK if any of the following Riders are applicable and are attached to this Contract):
(a) D COASTAL CONSTRUCTION CONTROL LINE RIDER (e) D FOREIGN INVESTMENT IN REAL PROPERTY TAX ACT RIDER
(b) D CONDOMINIUM RIDER (d) 'D INSULATION RIDER
(e) D FHA/VA RIDER
(f) D OTHER:
XI. ASSIGNABILITY: (CHECK (1) or (2)): Buyer (1) D may assign or (2) D may not assign this Contract.
XII. SPECIAL CLAUSES: (CHECK (1) or (2)): Addendum (1) D is attached or (2) IS there is no Addendum,
XIII. TIME IS OF THE ESSENCE OF THIS CONTRACT. BUYER'S INITIALS
XIV. DISCLOSURES: Buyer D acknowledges or D does not acknowledge receipt of the agency/radon/compensation and estimated closing costs disclosures,..
THIS IS INTENDED TO BE A LEGALLY BINDING CONTRACT.
IF NOT FULLY UNDERSTOOD, SEEK THE ADVICE OF AN ATTORNEY PRIOR TO SIGNING.
THIS FORM HAS BEEN APPROVED BY THE FLORIDA ASSOCIATION OF REALTORS AND THE FLORIDA BAR.
Approval does not constitute an opinion that any of the tenns and conditions in this ContIact should be accepted by the parties in a particular transaction. Terms
1u and conditions shirOUd be ne tiated based upon the respective interests, objectiVes and bargaining positions of all interested persons,
T ~ ' f f ((!jA ~ W - T~ C IGHT 1991 BY T~E..:L~R~~B~ ~N!: T~E!L~R.!?A_A~~IATION OF REALTORS
y: 1. ~'~ ,~~ r 1. g '<.~ 1. ~ IS', etf: Date / '74, -; ;se::tar -?1L/ ~ Zf> -:,j// Date
-.t~.:e!~~~fa~ C i ; Y C 1 or .fI;t.>JfL_:Qa t e ""'oj s~r' 0; T~ ID' 8\- g;~- 1<-- \\ IS
.:: <f[/ I sifl Date I../' Y.i..L,;/~ t. _ a.I. - , 7. ;2.$4 J Date
_ Q m-m'-1.-5 s ion e r ' (Seller) T
<. _..d..tA:!-~ .' " ~< . Jr,fS;&L_Q ate Social Security or Tax 1.0. # ~~ - 5o-D\ D~
D~:~7i ~n;k~~ggt~(~)~~!vem; 'OhtERJHAM CASH, t.fE~~~~T TO CLEARANCE.
BROKER'S FEE: (CHECK AND'OOlli1PlJ~TE .THE ONE APPLICABLE) By:
E9 IF A LISTING' AGREEMENT is CURAeNi'1.Y IN EFFECT;
Seller agrees to pay the Broker named below, including cooperating sub,agents named, according to the terms of an existing, separate listing agreement:
OR
D
(Escrow Agent)
IF NO LISTING AGREEMENT IS CURRENTLY IN EFFECT:
Seller agrees to pay the Broker named below, at time of closing, from the disbursements of the proceeds of the sale, compensation in the amount of (COMPLETE ONLY ONE)
_ % of gross purchase price or $ for Broker's services in effecting the sale by, finding the Buyer ready, willing and able to purchase pursuant to the foregoing
Contract. If Buyer fails to perform and deposit(s) is retained, 50% thereof, but not exceeding the Broker's fee above provided, shall be paid Broker as full consideration for Broker's
services, including costs expended by Broker, and the balance shall be paid to Seller, If the transaction shall not close because of refusal or failure of Seller to perform, Seller shall
pay the full fee to Broker on demand. In any litigation arising out of the Contract concerning the Broker's fee, the prevailing party shall recover reasonable attorney's fees and costs,
(fi'm"~ of I",'" 8m"", (f;~ - of ."., 8mke,' (~1Jf~~
By: By. ~ 1e4
(authorized signatory) (authorized signatory) (Seller)
RIDERS CAN BE OBTAINED FROM lliE FLORIDA ASSOCIATION OF REALTORS OR THE FLORIDA BAR.
FAR/BAR 002A-90a Rev, 1/91
SI::JOJ,l\f::JtJ 10 UOljBpOS8\f BP!JOI~ e41 pue Je8 epuol" eq1 Aq ~ 6m j46uAdo:)
F. I 'JOA"8, OJ pesopslp 1I88q JOU 8Aeq
lPILlM JO J8,\n8 Aq 8lqe^J8sqo '\llpe8J IOU 8JB qO!qM Aj.OJd IB8tJ 8qj 10 8n1B^ 8Llj 6Ulp8jjB AIIBU8jeUJ J8118S OJ UM ~ spq Oll 8JP 8J8llj jeLlI SjUBJJBM JGIIDS :c,::JI.U !\lUU\1M'M
'jl '\q pllnoq 8q OJ p8pU8jU! s8ljJed JO AjJed 8Llj Aq p8jn88X8 pue 6UljUM UI SS81lll1 S81jled 8Llj uodn 6UlpUlq 10 P!let, 8q lIeLlS pe,I)Uo:) S!Llj
UI 86ueqo JO uOljeol)lpOW oN 'peJ1UO:) slqj U! pepnloul sS81un Jelles JO J8An8 uodn 6ulpulq 8q 118qs slIolj81UeS8Jd8J JO SlU8l1l88J68 jlles8Jd JO JOIJd oN :S1N::JVIJ::::UDIi U:.III,LO '^
'uleJeq JOj P8PI^OJd 8SIMJ8l1!0 eq A8UI S8 SJ811BUJ qons OJ AIUO p81qns '8ljlj )0
AjU8JJBM qjlM el8s )0 lI'q 8jnlosqB U8 Aq P8JJ81SUBJj 8q 'J8An8 10 jS8nbeJ j8 '1I84S AjlBUOSJed 'JeAn8 Aq pejd800B 8sIMJeLljo eSOll! pUB II^ qd8J68J8d III P8Ul8jUO:) SJ8nBllI OJ AIUO p81qns
'J8118S )0 snjBjS 8qj OJ ejeudoJddeSB 'p88p S,UB!pJBn5 JO S,e^'jBjueseJd8J IBUOSJed 'S,eejsnJj 'AjUBJJ8M AJOjnlBjS Aq Ap8dOJd 1881::J 8lH OJ eljlj A8AlIOO 118LlS Jel188 :::J:::JN\1A3^NO::> 'n
',\jJed jeqj OJ JO Aq u8AID I' se eAlpejje S8 8q III)ll8 A1JBd '\ue JOj A()lUOne eLlj OJ
JO '\q u8AID 80!jON 'lie epnpul 118LlS J8pue5 euo pue 18Jnld epnloul lIeqs J81n5uIs 'sj!wJ8d jX8jUOO 8qj J8A,8U3lli.\ 'jSaJ8jUI UI SJOSS800ns Jleqj PU8 8Glp8Cl aqj 10 j1F'U8q 8qj OJ eJllU!
pUB pUlq IIBLlS peJjUo:) SIq1 'SpJ008J O!lqnd AUB UI p8pJ008J 8q IIBqs 'jl )0 801j0U AUB JOU 'pBJjUO:) S!qj J8qj'81, :3::>110N [aNnos SNOSl:J3d [3lS\1Ul:J0:.l3l:J 10N L.l\1l:J1NO::> '1.
'qOB8Jq S,JeI18S WOJ) 6u!jlnS8J s85BWBP JOI UO!PB AUB 5UIAIBM '\qaJ8LlljnOLljlM (s)jlsod8p S,J8An8 )0 UJnj8J 81.11 8AIGOaJ 0) )0818 JO 80UBWJO)J8d
01)108ds ~88S ABW J8An8 8qj 'pBJjUO:) slqj WJO)J8d OJ S8Sn)8J JO Spal58U 'SltH) J811aS 'jJOjje jU86111P J8jjB 8IqBla~JBW 811!j S,JaIl8S a~BW OJ J8118S )0 8,1111'8) umn JaLllo UOSB8J Aue JO) 'Ji
'pBJjUO:) S!'l! J8pUn 8jq61J S,J8118S 80JOlu8 OJ Ajlnb8 UI p8800Jd ABW 'uoljdo s,Jalles jB 'Jellas JO :PBJjUO:) J8pUn SUOljB5!1qo liB )0 P8A8!18J 8q IIBqs J81188 pUB J8An8 'UOdn8J8qM :SW!BP
AUB )0 jU8W81ll88 IInl III pue pBJjUOC) slqj )0 uOl)noex8 eqj JO) uOljeJeplsuoo 's85BWBp p8jBp!nbll uodn p88J5e SB J8118S )0 junoooe 8qj JOI .10 Aq p8UlBj8.1 aq ABW 'plBd 8q OJ p88J5e
(S)j!Sod8P pUB J8An8 Aq plBd (8)j!sodep 8Llj '(s)j!sodep liB )0 jU8WABd 5ulpnpu! 'P8!)p8ds 8WII 8L1j U!qj!M pBJjUO:) SILll llUO)J8d OJ 81tHI J8An8 !I :3:>N\1I1\1l:J0"l:J3d ,,0 3l:Jn111f:l 's
'SjSOO pUB S88) S,A8UJO)jB 81qBUOSB8J J8A008J OJ p81l!!ue 8q IIB4S 'J8~OJq 8,J8An8 JO J8~OJq 6uljSII 8111 OJ sju85eqns AlIB PU8 J8~OJq 8,J8An8 'J8~OJq 5u!jS!1
'J8An8 'J81188 8pnpUI 118qS 'pJBpUBjS slqj )0 sasodJnd 8Llj JO) '40!YM uOl)B51jll yons U! APBd 5U!I'BA8Jd 8qj 'pBJjUOC) Sill! )0 jno 5UISIJB uOlj(51)!1 ,\U8 ul :SlS0::> [S33~ S,A3Nl:J0111f 'l:J
'jU8D\1 )0 80U8DI168u SSOJ5 JO pBJjUO:) S!qj )0
40B8Jq In)II!M OJ 8np SI AJ8^'18PSIW qons sS81un 'MOJOS8 S!Yj OJ p8fqns SW8j! )0 J8118S JO J8An8 OJ AJ8A!18PSIW JO) uosJad JO AjJBd AUB OJ 81qB!1 eq JOU IIBqS jU851f JBLlj 88J5B Se!pBd
'AjJBd 5ulltH^8Jd 8qj )0 JOAB) UI SjSOO pnoo S8 p8pJBMB pUB p85JBLlO pUB jU8IB^!nb8 JO spunl p8MOJOS8 8Llj )0 jno pUB lUOJ) pl8d 8q OJ SjSOO pUB S88) 8qj LljlM p8JJIlOUI SjSOO pUB
S88) S,A8UJO)jB 81qBUOS88J J8A008J IIBLlS jU85\f 'MOJOS8 8qj )0 J8)jBW p81qns 8Llj SPB8IdJ8ju! jU85\f U!8J8qM jlns AUB UI JO 'JepUn8J8q jue5\f SB 5ul)::m )0 8snB08q AjJBd B 8pBW S!
jue5\1 uI8JeLlM J811eS pUB J8An8 UeeMjeq jlns AU\f 'papueWB S8 '(6861) 'S'~ 'SLv J8jdBLlc) )0 SUOIS!AOJd Llj!M Aldwoo 11'M jue6\1 'Je~oJq 8jBjSa IB8J P8SU80!1 B )1 'MOJOS8 )0 jno P8J8Allap
AISnO!A8Jd SW8jl AUB JO) 5uljUnOOOB )0 jU8jX8 84j OJ jd80X8 '8jBU!WJaj Alln) 118qs jU85\f )0 pBd 8qj uo Aj!l!qBII liB 'UOIjOB Llons )0 p8UJ80UOO S81)JBd liB 5U!AjljOU uodn '8jndslp 8qj )0
UOlp!pS!Jnf 6UIAB4 pnoo jll10JI0 84j 10 ~J810 eLlj qjlM aWBS j!Sod8P ABW jU85\1 JO S81pBd 84j )0 Sjlj51J 84j 8UIWJ8jep 118qS UOljOlpslJnl jU8j8dwoo )0 jJnOO B )0 jU8w5pnl B I'jun JO
jU8WaSJnqslp Sj! OJ 8eJ5B AIIBnjnW S8!jJBd 8qj I!jun MOJOS8 eqj 10 J8)jBW p8rqns 84j Ploq OJ 8nUljUOO 'UOljdo S,jU85\1 jB 'ABW jU85\f 'pBJjUO:) 10 SUOIS!^OJd 8qj J8pUn S81j!lIqB!1 JO
sel)np s,jua6\f OJ se jqnop U! II 'eOUBwJojJad S)eAn8 esnoxe JOU IIBLlS spun) )0 eOUBJBep )0 eJnI!B~ 'pBJjUO:) )0 SUOI)IPUOO pUB SWJaj qjlM aOUBpJOOOe UI W8qj aSJnqslp '80UBJBep OJ
pefqns 'pU8 MOJOS8 U! 8wes PlOY 'AljdwOJd W84j jlsodap OJ W84j )0 HOUBjd800B Aq s8aJ5B pUB p8zuoqjnB SI jU81BAlnb8 JO spun) 5U!A!808J (..ju8b\1,,) jU86B MOJOSa AU\1 :MOl:J::>S3 '0
'p8pU8WB SB '(68m) 'S'~ '~v8L'LG9 UOlp8S OjlUBnSJIld SJ8)jBW 8SJ8ApB S8JnSUljU85B 81jlj )! p8AIBM 8q ABW
pJBPUHjS slqj Aq peJ!nb8J 8JnpeooJd 5u!sop pUB MOJOSe 8q1 'J05e5pow-J8An8 OJ 8lqBjnqlj)je P818P 81jlj AUB )0 jlnS8J B SB Sp8800Jd e5B5pow )0 IU8W8SJnqSlp PIOLlqjlM JOU 111M j! jBqj
jU8WjlWWOO U8)jUM B UO!jnl!!SUI 5u!PU81 84j WOJ), 8Jlnb8J OJ jLl5!J 84j 8ABLl IIBq8 Jelles 'pBJjUOC) slqj UI UOISlt,OJd AJ8JjUOO J8AO 10JjUOO IIBqs Sp8800Jd 85861JOW )0 jU8UI8S,tnqSlp JO) pUB
'5ulsop JO) 88Jnp800Jd pUB ABP )0 eWI) 'eOBld OJ SB UOl)nj!jSU! 5U!PU81 eyj 10 SjueWeJ!nb8J '5UIOUBUI)8J JO 6UlOUBUII 18UO!lnjljSUI WOJI p8AIJ8p 8q OJ S! 80IJcl8sBqOJnd 8Llj 10 UOllJod 8 II
'pa8p 8qj UI peUIBjUOO sequBJJeM )0 8njJ!A Aq JeAn8 OJ elqBIIBAB eq ABW SB jdeoxe pe)8p 5U!U8^J81UI '\ue OJ S8 J8118S jSUI85B Sjq5u liB 5UI^'BN\ '81 SB 81l!! 8~Bj Ileqs J8An8 'pun)eJ
JO) PUBW8P AI8WIj 8~ew OJ slIe) JaAn8 )1 'P88P A1UBJJBM IBp8ds Aq Jal18S OJ j! AeAU008J pUB AjJadoJd "jB:JeA PU8 AjleUOSJ8d UJnj8J IIBqs J8An8 'jU8WAed8J qons qjlM AISIl08UBjlnW!S
PU8 J8An8 OJ p8UJnjaJ 8q 'pUBwap JajjB SABp 9 U!LljIM pUB J8An8 Aq pUBwep U8)jIjM uodn 'IIBLlS spun) DlIISO:') pue (sll!sodap liB 'p8)ap aqj 8JnO AI8WIj OJ SI'B) J81188 )1 P8)8P 8qj
8Jno OJ UO!jBOI)!jOU qons )0 jdlaoaJ )0 ajBp WOJI SABp OS e^BLl IleLls Jal18S pUB P8)8P 8Llj )0 6UI)UM UI J81i9S ,1)ljOU 'pOIJ8d ABP'9 8qj UILljlM 'IIBq8 J8AIl8 '.IaAn8 )0 line) all q5nOJLlj
'8IqBje~JBwun peJepueJ SI ell!l S,Jelles )1 'ejBp 5u!sop JejjB pUB WOJ) SABp 9 UB4j J85uOI JOU )0 pO!J8d B JOI lua5e MOJOS8 81qBjdaoOB AII8njnUI J8LljO qcms Aq JO A8UJO)jB s,J8118S Aq
MOJOS8 UI Pl8Ll 8q IIBLls 81es aqj )0 spe800Jd 'aOUap!Aa JSBI 8qj 10 ejBp 84j WOJ) 8lqBj8~JBwun eljlj S,J8118S J8pU8J PlnoNl qOlqM 86uBqO JO S80UBJqlllnoU8 AlI8 lnolil'M 'J8,\1l8 U! 81l!!
MOqS OJ 8SU8dx8 S.J8An8 jB p8nUI)UOO 8q IIBqs 81jlj )0 80U8P!A8 'pBJjsqe )1 'spun) )0 80UBJe8p uodn p8pJOO8J 8q lIeqs p88p 8q1 :3l:Jna3::>OHd DNISOl::> [3'WS ~O Sa33::>0l:Jd 'd
'(s)j!sodep )0 uJnjeJ 6UI^!80eJ pUB pBJjUO:) slqj 5U11180ueo )0 JO '85Bwep JO SSOI qons )0 81ljJIA '\q 81qBAecJ Sp0800Jd 80ueJnSUI AUB
JO %S 8qj J8qj!8 qjlM J84j850j 'S! se AjJ8dOJd 5U!~Bj J84j!8 )0 UO!jdo e41 8^B4 IIBLlS JHAn8 'p85BWBp os SjU8W8^OJdw! 84j )0 uOl)enlBA p8SS8SS8 8qj )0 %S 8p880X8 UOqBJOjS8J )0
JSOO 8Llj )1 '5u!sop jB p8MOJOSe SjSOO UOl)BJOjS8J Llj!M pBJjUO:) )0 SWJ8j 8Llj OJ juensJnd p8800Jd lIeqs 5uIsoro pue J8118S 8qj )0 UOlje511qo UB 8q IIBLls UOljBJOjS8J 10 JSOO 'p85BWBp
os AjJ8doJd 8Llj )0 UO!jBnIBA p8SS8SSB 84j )0 %S p880X8jOU S80p UO!IBJOjS8J 10 JSOO pue 5U1sop 8JO)8q AjlenSeO J8qjO JO 8JI) Aq p85BWBp 81 AjJ8dOJd 8L1j )1 :SSOl ~O )lSIl:J '0
'p8jd80X8 JB8j pue JB8M AJBUlpJO 'p8jUBJJBM U!8Je4 UO!j!PUOO 8Llj UI 'AJ8qqnJqs pUB UMBI 8Llj 'OJ P8jlWlljOU jnq '5U1pnpul 'Ap8doJd lllPjUI8W IIBLlS J8118S
'pJBpUHjS S!Yj Aq p8JlnbeJ SJ!BdeJ JO) jdeoxe '5u!sop )0 ejBp e4j pUB 8jBa 8A!pH1J3 U88Mj8S '5u!sop OJ Joud Ll5noJqj'~IBM e 5utpnpuI 'SUOlp8d8UI JO) Ap8doJd 8Llj OJ SS8;)OB pUB
80lAJ8S se!l!ll)n ep!AoJd 'eOI)Ou elqBuoSBeJ uodn '111M Jelles '5u!sop jB MOJOS8 OjU! plBd 8q IIB4S )08J8qj JSOO 8qj '5ulsop OJ Joud Sp8j8p 8qj p8JJOO 0) 81qeun Sl J8118S )1 peJjuo:) S!Llj
180ueo Aew ApBd Je4j!e 40!4N1 5UmB) 'sseOX8 yons ABd OJ pel8 ABW Jell8S JO J8AnS '80ud eseqoJnd 8qj )0 %S Sp880X8 jU8W80eld8J JO SJIBd8J qons JO) JSOO 8qj )1 'NOI1IaNO:)
8NI>lI::JOM UI SW8j! qons 80Bld OJ J8pJO U! p8J!nb8J 8q ABW SB SjU8W80Bld8J JO sJ!BdeJ qons JO) 80ud 8SBqOJnd 8qj )0 %S OJ dn ABd 118qs pUB 8pBW 8q OJ SJIBd8J Llons 8SIleo IIBqs J8118S
'p8JtnbeJ 8JB SjU8W80Bld8J JO SJ!Bd8J )1 'p8jJod8J JOU Sp8)ap OJ SB S8!jUBJJBM S,Jelles peAIBM eABLl OJ p8W88p 8q IIBqS J8An8 '8WI) j8Llj U1LllIM Sp8)ep Llons SjJOcJ8J J8An8 SS81Un
'Sp8j8p OJ SB SpJ8pUBjS 8AOqB 8qj j88W JOU op JBYj swej! 40ns Jell8S OJ 5U!jIjM U! podeJ 'jSJ!) SJnooo J8A8LlolqM '5ulsop OJ JOud SABp m uelll SS81 JOU JO AOUBdnooo S,J8An8 OJ
JOljd 'IIBqs J8An8 'JOp8JjUOO ep!JOI~ P8SU80!1 AI8jeIJdoJddB ue Aq JO (p8J!nb8J )Il esodJnd qons JO) 8SU8011 IBUOI)Bdnooo UB 6uIPIOLl pue SUOlP8dsUI 8woq UI 5uIZIIBp8ds IBnp!A!PUI JO
WJ!) B Aq SW8j! 8S0Llj )0 epBw suo!pedsu! 8^BY 'esuedx8 S,J8An8 jB 'ABW JeAn8 'NOI1IaNO:) 8NI>lf::lOM U! 8JB AJ8U!40BW pUB SW8jSAS 5ulqwnld 'IBOIJP818 '5u11000 '5u1)BeLl 'SW8l!
IBO!UBLl08W 'S80UBllddB liB 'Iood '~uej 0l)d8S 8Llj jBqj pue 85ewBp leJnpnJjs JO e5BwBp J8jBM 'S~B81 )0 ::J:)N::JOI^::J ::J18ISI^ AUB eABLl JOU op 85B~00p PU8 (ju8lBAlnb8 JO) SIIBMB8S
'sIIBM JO!J8jU! pUB JO!J8jX8 pUB (Sj!jjOS pue BlOse) 8Llj 5u!pnpul) )OOJ '5u!1I80 8Llj '5u!sop OJ JO!Jd SABp O~ )0 SB 'jBLlj SjUBJJBM J8118S :3::>NlfN31Nllfll\l aNIf l:J1\1d3l:J 'NOI1::>3dSNI 'N
'ApOq ollqnd 8qj Aq jU8W8^OJdw! 84j JOI jU8WSS8SSB 10 8jBWI)S8 JSBI eqj Ojl8nb8 jUnOWB ue p85JBLlO 8q '5uI801;) jB '1lBqs J8118S pUB P8!I!j8J JO
pewJI)UOO 'p81j1)J80 p8J8P!SUOO eq IIBqs U811 5u!pued 40ns '8jBa eA!j08)j::J )0 SB P8j81dwoo AIIBl)uBjsqns u88q SBq jU8WeAOJdwI 8qj Ji 'J8An8 Aq p8wnssB 8q IIBLlS 5u!sop 10 8jBp )0 SB
SU8!1 5U!PU8d 'J8118S Aq P!Bd 8q OJ 8JB (8lBa 8^!P8jj::J 10 SB jOu) 5U1sop )0 8jBp )0 SB sue!1 jU8WSS8SSB lepeds pel)ljBJ pUB P8WJ!IUOO 'P8!I!jJ8:) :SN31l 1N311\1SS3SSIf llfl::>3dS '11\I
'jU8W8jBj8 5uIsop 8qj UI SI p8jj8 jBqj OjjU8W8jBjS B jBqj UO!j!PUOO uo II'q X8j )0
jdl808J lIodn p8jSn!pB8J AljU8nb8sqns 8q 'J8118S JO J8An8 JH4j!e )0 jsenbeJ jB 'IIBqs 8jBW!jS8 UB UO p8SBq UOljBJOJd XBj AU\f 'suol)dWex8 elqBI!BAB UO!jBJ8pISUOO OjU! 5UI~Bj jU8WSS8sse
IBWJOlul ue JOI Jes!BJdd\1 ApedOJd AjUno:) e4j OJ epew eq II!M jS8nb8J 'LlO!YM 5u!I!B) 'se!pBd 8Llj U88Mj8q uodn p88J6B 8q OJ jU8WSS8SSB 8lqBj!nb8 ue jB pUB 85BII!W S,JB8A Joud
8qj uodn p8S8q p8jBJOJd 8q IIB4s S8XBj U84j 'Je8A JO!Jd 8qj )0 jS~ AJBnUBr uo 80UeIS!Xe UI JOU eJ8M SjU8W8AOJdw! LlO!qM 5uIsop )0 JB8A )0 jS~ AJBnUBr Aq AjJ8doJd IB88 e4j uo
SjU8WeAOJdwI P8jeldwoo eJB 8JeLlj )1 'XBj S,JB8A JO!Jd 8LljUO P8jBJOJd 8q II!M S8XBj U8qj 'elqBI!B^B JOU SI jU8W8S8sse S,J88A jU8JJIl0 II '85BIIIW S,J88A Joud 8ln pUB jU8WSS8SSB qons uodn
p8SBq p8jBJOJd 8q II!M S8XBj 'elqBI!B^B SI jU8WSS8SSB S,JB8A jueJJno pUB P8X!) JOU S! 85BIIIW S,JB8A jU8JJno 8111 U8qM 8jBp B j8 SJnooo 6uIsop II 'SUOljdl!J8X8 J8qjO pue p88j88WOLl
'junooslp 81qBMolle wnWlxBW JO) epBw 80UBMoIIB 8np 4jlM XBj S,JBeA jU8JJno eyj uo p8SBq p8j8JOJd 8q !18LlS S8X81 'J8118S OJ p8jlp8JO 8q 11'M 88586pOlU Aq Pl8q Sjlsod8p MOJOS8
pUB J8An8 OJ p8jlp8JO 8q 11'M Sj!Sod8P Alljn08S pUB jU8J aOU8Ap\f '5U1sop 8JO)eq SJnOOO AOUBdnooo )! AOllBdnooo OJ Joud ABP lj51l0Jqj 8pBLU 8q II!M 8UOljBJOJd 'SUOljBJOJd '\q p8Jlnb8J
8q A8W SB p8SB8J08p JO p8SB8JOU! 8q IIBLlS 5u!sop jB qSBC) 'pejBJoJd 8q IIB4S swn!w8Jd jU8A8 qOlqM UI '8lqBwnssB )1 '80U8JnSUI )0 S8101lod 6UI)S!X8 AUI', J8AO 5ul~8j )0 uO!jdo 8qj
8ABq IIB4s J8An8 '5uIsop 8JO)8q ABP 45nOJqj p8jBJOJd 8q IIBqs AjJ8doJd 10 8nUeA8J pUB s8suedxe J8qjO pUB eoueJnSUl, 'jS8J8jUI 'jU8J 'SjU8WSS8SSB 'S8XB1 :Slla31:1::> 'SNOI1lfl:JOl::ld '1
'J8An8 Aq P!Bd 8q IIBLls SjU8W8jB)S 5uloUBUII pUB p88P 'J8118S OJ 85B5jJOW
Aeuow eseLloJnd 5u!pJooeJ pue XBj 8Iq!5uBjU! 'SdWBjS AJBjU8WnOOa 'Jelles Aq plBd 8q IIB4S sjuewnJjsu! 8Alp8JJOO 5u!pJooeJ pUB pe8p 84j UO SdWBjS AJHjU8WnOOO :S3SN3dX3 ')I
'SjU8W8jBjS 5U!OUBUII PUBjU8W88J5B AjIJn08S '8jOU 8585jJow '8585jJOW 'jU8W8jBjS 5U1sop qSIUJnl lIeqs J8An8
'SjuewnJjSU! 8^!p8JJOO pUB SJe)jel18ddojse e85B5jJOW pUB jUBU8j 'S8SB81 )0 sju8wu5!SSB 'j!ABpljjB U8!1 S.o'U8q08W '8IBS 10 II'q 'P88P 84j qS!uJnl IIB4s J8118S :DNIS01::> I:IO~ SlN311\1n::>Oa 'r
'ABp sseu!snq jxeu eqj )0 'w'd 00:9 OJ PU8jX8 IIBqs ABPlloq IB581 B JO ABpuns 'ABpJnj8S uo PU8 118qs 40lqM
u!eJeq JO) p8plAOJd pOIJed eW!j AUB pUB 'SABP!IOLl IB5el IBUOljBU JO 8jBjS pUB SABpuns 'SABpJnjBS 8pnpxe UO!jBjndwoo 8YI UI IIBqs S.^BP 9 uBqj SS81 )0 U18J84 spo!J8d 8wl1 :311\I11 'I
'J8118S Aq p8jBU5!S8P jUe5B 5uIsop J8qjO JO AaUJo)jB aLlj )0 80!jjO H4jjB PHjBOOI S! AjJ8doJd IBe8 8qj UleJ8qM AjUnOO 8qj U! Pl8q eq IlBqs 5uIsoO :8NISOl::> ~O 3::>lfld 'H
'pBJjUOC) S!LlI 10 5u!sop jB P!Bd eq 111M JO P!Bd U88q 8^B4 s85BWBP JO) WlBp B JO u811 s.o!UB408W 8 JO) SISBq B SB 8^J8S Plnoo qOlqM SJIBd8J JO
Sjuewe^oJdWI JO) Se5JBYO liB JBYj 5UIWJ!IJB Je4pn) pUB UeWIB!J8jBW pUB SJ811ddns 'SJOpBJjUooqns 'sJopeJjuoo IBJ8u85 yons liB )0 S8WBU 8qjLljJO) 5U!)j8S jl^BP!jjB U8!1 s,J8118S 01 UOlj!PpB U!
U8WIB!J8jBW pUB SJ8!lddns 'SJOpBJjUooqns 'SJOpBJjUOO leJ8U85 liB Aq pejnOeX8 suell ,SO!UBLlOeW )0 SJ8^'BM JO S8SB818J J8AI18P lIeqs J8118S 'ewl) jeqj UlqjlM peJIBd8J JO p8AOJdw! u8eq SBLl
AjJ8dOJd II '5u!sop 10 8jBp 5U1p80eJd AlejB!p8WW! SABp 06 JO) Ap8doJd 84j OJ sJ!BdeJ JO SjUeW8AOJdwI ou U88q 8^BY 8Jeqj JBLlj 5uljse)je J8LljJn) pUB J8118S OJ UMOU~ SJOUell lel)U8jod
JO Ue!1 )0 SW!BP 'SIUeWejBjS 5UpUBU!) AUB 10 'U!8J84 JO) pep!AoJd 8S!MJ84jO SS81un 'eouesqe e4j Qj 5UIjS8)jB jl^BptjjB UB 5U!SOI0 )0 8WIj jB J8AIl8 OJ 4SIUJnl lIe4S J8118S :SN31l '8
'J8An8 OJ s8se811BU!51JO liB U51SSB pUB J8AI18P
'5u!sop jB 'IIBqs J8118S 'UO!jBWJO)U! qons WJ!IUOO OJ SjUBU8j pBjUOO J8jjB8J8Llj ABW J8An8 pUB 'j!^BP!jjB S)8118S B )0 WJO) 8Llj UI pO!J8d 8Wlj jBqj UIlH'M J8An8 OJ J8118S Aq peqs!uJn)
8q IIB4S UO!jBWJO)U! 8WBS e4j 'jUBU8j 40B8 WOJ) J811el 40ns UlBjqo OJ 81qeun S! J811eS II 'jUBU8j Aq plBd Sjlsod8p AjUn08S pue jU8J P80UB^PB 'S8jBJ 18jU8.1 'AouBdnooo S,jUBU8j 8qj )0
UOI)BJnp pUB 8JnjBU 84j 5UIA)!08ds jUBUej qOB8 WOJ) SJ8)j81 18ddOjS8 pUB s8se81 U8)jpM lie )0 s8!doo J8An8 OJ qSluJn) '5U1sop 8JO)8q SABp 9~ U8qj SS81 JOU '11eq8 J811aS :S3Slf31 '~
'\1 pJBpUBjS qjlM 80UBpJOOOB U! 81 qOILlM OJ 8lj!j
')08J8q II^ qdBJ5BJBd UI p8qpOS8p SB 8sn p8pU8jU! 8qj JOI jU8p!jjnS A)J8doJd IB8l:! e41 OJ SSeJ58 pUB SS8J5u! SI 8Je4j jB4j SjU8S8Jd8J pUB SjUeJJBM J8118S :SS3l:JD3 ONIf SS3l:J8NI '3
'p\f 10Jjuo:) jS8d 8puol~ 8qj J8pUn p8)Jod8J 8q OJ p8Jlnb8J swslue5Jo 5U!AOJjS8p
pOOM liB 8pnpU! OJ p8W88p 8q IIB4S "S8j!WJ81" '80pd 8SB40Jnd aqj )0 'loG )0 sseox8 UI JOU 8jeWljSe J!Bd8J pUB jU8WjB8Jj 8qj 10 IBjOj 8qj OJ IBnb8 jUnOWB UB )0 5UtSOp jB j!P8JO B
8A!80eJ 118YS J8An8 jU8^8 40lLlM UI 'UO!pBSUeJj 84j Llj!M p8800Jd OJ pale ABW JeAns JO Jelles OJ eOI)OU U8)j!JM 5UIA!5 Aq 8jBWI)S8 Jled8J' S,JOpBJjUOO )0 jd!80eJ J8jjB SABp 9 U!qj!M
pBJjUO:) 5u'I180UBO 10 uOl)do 8LlI 8ABY IIB4S J8Ans 'jUnOWB jB4j p8Hoxe SjSOO 40ns Pln04S 'eoud eSBqoJnd 10 'loG OJ dn e5BWBp liB )0 JIBd8J pUB jUeWjBeJj )0 SjSOO pllBA ABd IIBqs
Jelles 'JOpBJjUOO IBJeue5 JO Jepl!nq pesueoll B Aq p8jBW!jSe pUB pepedsu! 'jOU JO Blq!S!A J84j84M 's85BWBp 118 eABY OJ qO!4M UllWMj08J"4l HOfjOO'UlillPM )0 8jBp WOJ) SABP17 eAB4
.!IIM J8An8 'puno) eJB Lljoq JO Je4jl8 )1 'sjueweAoJdwl 8Llj U! uOl)BjS81UI 8jlWJ8j WOJ) 85BWBP 5UI)SIX8 81q1SI^ JO UOljBjS8)U! 8jlWJej 8A!PB _81'1!SIA AUBS!. 8Ja1:iL)1 eUIWJ81ep OJ JOjeJ8dO
10JjUO:) lS8dY8!)!lJ8::> B~POI~ B Aq P8P8dsu! AjJ8dOJd IB81::J 8ABq ABW '8WBS 8U!WBX8 OJ pUB 8lj!j )0 80U8plA8 J8AII8P OJ P8MOIIB 8Wlj !JIY~ ;>>s!Jadl/8, S~J8frl8, 1&~HAn8:S31'11I\Il:J31 'a
, . ','. ' , " ' .:," 'P8)8P 8lj!j B 8jnj!jSuoO lIBqs 8WBS 8qj 'UOI)Bln5.wi'e~wu-JeiiofJ elqB::lj.jdd\:l'JQ :S)UBU8Aoo 10BJjuo:)
'suOI)OpjS8J AUB 8)H10!A JO SJ8qjO )0 spuBI 'SjU8WeSB8 'S8U!I ~oBqj8S UO 40BOJOU8 A)J8doJd IBel:J uo pejeool 8jU8ui8AOJdw! j8Llj JO A)J8(jpJd,f\388 uo jU8WLlOBOJoua- SMOLlSA8^Jns )1 'JOAe^JnS
BPPOI~ p8JejsI58J B Aq p8!jI)JeO pUB peA8AJnS AjJ8dOJd IBe8 eAB4 ABW '8WBS eU!WBXe OJ pUB 8lj!j )0 80Uep!Ae JHA!l8p OJ P8MOI18"8llJ!j U!4j)M '8Sv:8dx8S,J8AQSJ.l'.. 'Je6n8 :A3Al::InS '::>
'UOeJ8Yj SjU8WAed O!pouad 84j P880X8 11'M jU8W^BcriBu!je4'i.85B5~:JOU:rlloolleq-lC? jl,-"qusW8jBjS 5UpllBU!1
pepJOoeJ Aq peOUep!Ae jU8waeJ5B Aj!JnOes B )0 U8!1 8yj OJ p8[qns 8q 'uo!jdo S,J8118S jB '11'M p8u51SSB JO P8A8AUOO 5U!8q S8Se81 i3UB AjIBU~ H\f, 'pejBOOI 51 i\;V3dQJd IB8ldo U!8J8LjM
AjUnOO 84j U! P8jBOOI S~UBq 18UOl)BU JO 8jBjS ,JO SUO!jnj!jSU! UBOI pUB S5U!ABS Aq p8zIII)n AIIBJ8u85 sju8weeJ5B Ajpn08S pUB sejOU 85B5j.l0LU'Se5B5pOw,u! pun001!JmuOjsno sesnBp
8JIIlbaJ fijUOA8W J~lIes jnq :Jell8S .^q p8J!nb8J juejUOO pUB,WJOj U! eS!MJe4jO eq IIB4S jUew88J5B Al!Jn08S pUB ejou 'e5B5pow 8Yj'pue[($~5jJoUJ JO!Jd Jepun S~U8^PB eJnjn) JO )0
SUO!IBOI)IPOW P!qJOj pUB 5U!PUBjS po05 Ut jd8~ 8q OJ SeOUBJqwnou8 pue suell Joud liB eJ!nb8J IIB4S :AjJ8doJd IB88' 10 81BS81 jo-'It:l8^!3 ll! lU<<.li1lsn[pE:, ,jseJejul JO ,uC'!iBJ8IeOOB jlwJed JOU
IIBYS :AjIBU8d jnOLlj!M pBd U! JO,8104M U! jUeWABdeJd )0 jy5!J JO) 8pl^oJd IIBYS :e5B5jJow J8SSel JO PU008S B )! pO!J8d 80BJ5 ABP-~J 'e-PUB 85B'fllJowjsJ!j~\ilUlnB)ep '19 jU~1Iii! e4j
UI pou8d 80BJ5 ABp-OS 8 JO) 8P!^OJd IIB4s J8118S 01 8jOU 85B5)Jow pUB (585)Jow A8UOW eS8LlOJnd \f :l:J3113S01. 1N311\133,l::IUIf A.1ll::1l};>3S :38lf8'1i:l0ll\l ^,,'Now 3SlfH::>l:Jni:l '8
'sj!ns AJBSS808U )0 5u!5upq eLlj 5U1pnpul 'JO)8J84j P8P!AOJd, eWI) eLli U!YW^ 8Ii!; a~pJ! (\lU:J1l)81" .)08JJOO OJ pOjj8 jU8511IP 8sn
'elqBjH~JBWUn punoj S! elm )! '11B4S Jelles 'pBJjUOC) eyj Jepun suol)B5!1qo JeLlIJn) liB 10 JeLljOUB 8UO eSB81aJ IIBqs J8118S pUB J8An8 'UOdn8J84j :J8A1l8' o'j p88Jnj8J aq AlejBlpeww! IIBqs LlO!LlM
P!Bd (s)jlsod8p )0 pUn)8J B 5U!PUBW8P JO S! ueLlj j! S8 elj!j 8qj 5uI)deoOB JeLljle 10 UOljdo eyj e^Bq IIBqs J8An8 LlolLlM 5UII!B) '(s)pej8p e4l.: il^OW84 ,Ot-LlOIYM U!Llj!M 80ljOU )0 jd!eoeJ
WOJj SABp OG~ eABLl II!M J8118S 'elqBj8~JBWUn 81l1) J8pU8J (S)pe)8p 8yj )1 '(S)p8)8P 5u!AI108ds 5UljUM U! J8118S A)ljOU 'SABp S U!Yj!M 'IIB4S -186n>3 '8A;P8),8P puno) SI 81jl) )1 'I! eUtWBX8 OJ
81m )0 80Uep!Ae 5U!A!eOeJ 10 ejBp WOJ) 'jU8WjIWWOO 81l!j )! 'SABp 9 JO 'pBJjSqB )!, 'SABp OS 8AB4 IIBqS J8Ans 'Mel' YjlM eOUBpJOOOB U! pUBjB8 BPIJOI::! 841 )0 Ajpoqjne Aq p8jdopB
SpJBpUBjS 81jl1 81qBO!lddB OJ 5u!pJoooe peU!WJ8jep 8q IIB4s 81l!j alqBj8~Jell\l 'pBJjUO:) 84j UI P811P8ds SUO!jBOII!IBnb JO SUOl)d80xe 'SeOUBJqwnou8 'SU8!1 OJ AIUO pe[qns elj!j 8lqeje~Jew
AaAuoo IIB4s J8118S '5u!sop 8JO)eq JO jB J8118S Aq pe5JBqoslp 8q IIB4s 40!4M esoyj pUB pBJjUO:) slqj UI 4jJO) j8S SUO!jBO!)!IBnb JO SUOl)d80xe 'S80UBJqwnou8 'suell OJ AIUO p8rqns
'A)J8doJd IB81::J 8yj OJ 8lj!j S,J8An8 5UIJnSUI 80!Jd eSBLloJnd 8Llj )0 jUnOWB e4j U! 80UBJnSU! 81m )0 AO!lod S,J8UMO UB 'J8An8 OJ p88p eyj )0 5U!pJ008J uodn 'JeAn8 OJ enSS! OJ 5U!88J5B
J8JnSU! elj!j p8SueO!l BPPOI~ B Aq p8nSS! jueWjlWWOO eOUBJnSUI alj!j \f (G) 'P!Bd Alln) I!jun 885B5pow JSJI) Aq )OeJ8Llj uO!jUej8J )0 jq5!J 84j OJ p8[qns 'J8An8 )0 ApedoJd 84j ewooeq
IIBYs pBJjSq8 e4j 'UOI)OBSUBJj SI4j )0 5u!sop uodn 'AjUnOO e4j UI AJBWOjSnO eq ABW SB 8jBp J8jBI yons JO 'spJooeJ ollqnd jS81pBe e4j Llj!M 80U8WWOO IIB4s qOl4M pUB ejBa eA!pejj3
y5noJYj pejBool SI Ap8dOJd IBe8 uleJeLlM AjUnOO 84j 10 spJooeJ ollqnd 8Llj U! pepJooeJ AjJ8dOJd IB8l:J e4j OJ 81jlj 5U!pejj8 sjuewnJjsul aqj jO S!SdOUAS 8jBJnOOB UB 8q OJ 5u!jJOdJnd
(WJ!) 5uI)sIxe ue Aq p8JJOO SB pe!)1)J80 U8Llj 5UI)SIX8 JOU jl) WJ!) pBJjSqB 5u!jslxe puB elqBjnd8J B Aq jueJJno j45nOJq JO p8JBd8Jd 8lj!j jO pBJjSqB u\1 (~) :31111 ~O 3::>N301A3 'If
:-:'""
SNOI.1:>YSNYH.1 :I.1Y.1S:I 'Y:lH HO.:l SOHYONY.1S
~ ~, I I OMB No, 2502,0265
MIS \ 1(99) ,
''A, U,S, DEPARTMENT OF HOUSING AND URB" DEVELOPMENT . B, TYPE OF LOAN
1. 0 FHA 2, 0 FMHA 3. 0 CONV, UNINS,
4, OVA 5. 0 CONV INS.
6, FILE 17. LOAN
NUMBER 91080075 NUMBER
SETTLEMENT STATEMENT
8, MORTG, INS, CASE NO,
C, NOTE: This form is furnished to 8ive you a statement of actual settlement costs, Amounts paid to and by the settlement agent are shown, Items marked
("P,O,c,") were paid outsi e the closing: they are shown here for information purposes and are not included in the totals,
p. NAME OF BORROWER: CITY OF CLEARWATER, FLORIDA
PO BOX 4748
ADDRESS: ("'T FT, 14h17
E, NAME OF SelLER: HARMOND M. HAYNES and VNIENNE E. HAYNES
ADDRESS: SelLER TIN:
F, NAME OF LENDER:
CASH TRANSAcrION
ADDRESS:
G, PROPERTY LOCATION: LOT 1, BLK "G" HIGHLAND TERRACE MANOR
a/k/a 1314 N. HIGHLAND AVENUE, CLEARWATER, FL 34615
H, SETTlEMENT AGENT: STEWART TI'ILE COMPANY OF CLEAR\'lATER, INC. SETTLEMENT AGENT TIN: 59-1433918
ADDRESS: 1290 COURT STREET I
CLEARWATER, FL 34616
PLACE OF SETTLEMENT: STEWART TI'ILE COMPANY OF CLEARWATER, INC. I. SETTLEMENT DATE:
ADDRESS: 1290 COURT STREET QC'IDBER 1, 1991
CLEARWATER FL 34616 274th DAY OF YEAR/91 REJIIlAIN
J, SUMMARY OF BORROWER'S TRANSACTION K, SUMMARY OF SELLER'S TRANSACTION
100, GROSS AMOUNT DUE FROM BORROWER: 400, GROSS AMOUNT DUE TO SELLER:
101. Contracl sales priLe 65.000.00 401. Conlract sales pme 65.000.00
102, Personal property ~02, Personal properly
103, Selllemenl charges 10 borrow (line 1400) 6.00 403 ,
104, 404
105, 405
Adjustments for items paid by seller in advance: Adjustments for items paid for seller in advance:
106, Cityllown taxes 10 406, C,lyflown laxes 10
107, Counly laxes 10 407 Counly,la',.s 10
108, Assessmenls 10 408, Assessmenls 10
109 10 409 to
110, 10 410 10
111. 4",
112, 412
120 GROSS AMOUNT DUE FROM BORROWER: 65,006.00 420 GROSS AMOUNT DUE TO SELLER:: 65,000.00 I
200. AMOUNTS PAID BY DR IN BEHALF OF BORROWER: 500, REDUCTIONS IN AMOUNT DUE TO SEllER: --i
201. Deposit or earnesl money -0- 501 Excess deposit (see InslructlOnsl ,
,
202, Principal amount of new loan(s) 502, Settlemenl charges to seller IIIn" 14001 4 876.00
203, Exisling 10an(s)laken subjecllo 503 Exisllng loan(sllaken sublecllo ,
204 504, payoll olllrsl morlgage loan BARNETI' MTG 51 314.94
205 505 Payoll of second mortgage loan
206. 506
207 507
208, 508
209, 509
Adjustments for items unpaid by seller: Adjustments for items unpaid by seller:
210, Cily /town laxes 10 510, Cilyllown laxes 10
211. County taxes to 511 County laxes 1/1/91 10 10/1/91 q74 4A
212, Assessments 10 512, Assessments 10
213 to 513 to
214, 514
215 515,
216, 516,
217 517
218, 518
219, 519,
220 TOTAL PAID BY/FOR BORROWER: -0- 520, TOTAL REDUCTION IN AMOUNT DUE SelLER:: 57, 165.42
300, CASH AT SETTlEMENT FROM/TO BORROWER: 600, CASH AT SETTlEMENT TO/FROM SelLER:
301, Gross amount due from borrower (line 120) 65,006.00 601. Gross amount due to seller (line 420) 65.000.00
302 Less amounts paid by liar borrower (line 220) -0- 602, Less total reductions in amount due seller (line 520) 57.165.42
303, CASH (K)<FRoMI (~oRRoWER: 65,006.00 603 CASH (KJ TO) IKXDfIIM}<SElLER: 7,834.58
SUBSTITUTE FORM 1099 SELLER STATEMENT.The information contained in Blocks E. G, H and I and on line 401 (or, if line 401 is asterisked, lines 403 and 404) is important tax information and is being
furnished to the Internal Revenue Service, II you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS
determines that it has not been reported, '
SELLER INSTRUCTION.llthis real estate was your principal residence. file form 2119, 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 and/or Sche1!ule 0 (Form 1040).
Y , d bit 'd 1. R. S
ou are reqUIre y aw 0 provl e
If you do not provide I . R. S
Under penalties ,Of perjur,y, I certify th~~t
rMA: 0 '1-+' ~ J V"
'"SeIier H7'lRJllOND . HZ\YNPS VIVFNI\TR R. H7\YNRS
with your correct taxpayer identification number.
with your correct taxpayer identification number. you may be subject to civil or criminal penalties,
number shown on this statement is my correct taxpayer identification number.
"
. .. I I PAGE 2 OF OMB No, 2502'()265
MIS tOI ,
-, .~ PAID FROM PAID FROM
L SEnLEMENT CHARGES BORROWER'S SELLER'S
FUNDS FUNDS
700, TOTAL SALES/BROKER'S COMMISSION Based 011 price S 65,000.00 @ 6 'to= 3,900.00 AT SETTLEMENT AT SETTLEMENT
Division of commission (line 7(0) as follows:
701$ 3,900.00 to C-21 ARTHUR M. MILLER, INC.
702, $ to
703, Commission paid at settlement 3,900.00
704,
800 ITEMS PAYABLE IN CONNECTION WITH lOAN.
801, loan Origination lee %
802, loan Discount %
803, Appraisal Fee to
804, Credit Report to
805, lender's inspection fee
806, Mortgage Insurance application lee to
807. Assumption Fee
808,
809,
810,
811,
9OO,lTEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE.
901. Interest from to @$ /day
902, Mortgage insurance premium lor mo. to
903, Hazard insurance premium lor yrs. to ..
.'
904, yrs, to
905
1000, RESERVES DEPOSITED WITH lENDER
1001. Hazard insurance mo,@$ per mo,
1002 Mortgage insurance mO.@$ per mo,
1003, City property taxes mO,@$ per mo, l;l,
1004, County property taxes mO.@$ per mo. "
1005, Annual assessments (Maint.) mo,@$ per mo.
1006, mo,@$ per mo, "
1007. mo,@$ per,mo,
1008, mo,@$ per mo,
1100 TITlE CHARGES:
1101. Settlement or closing fee to
1102, Abstract or title search to STC 100.00
1103, Title examination to
1104, Title insurance binder to
1105, Document preparation to
1106, Notary fees to
1107, Attorney's lees to to
(inc/udes above items No,: 1 ~
1108, Title insurance (1101 ) to STEWART TITLE COMPANY OF CLEARWATER. INC.
(inCludes above items No.. "
,
1109, lender's coverage $
1110, Owner's coverage $ 65 000.00
1111.
1112, I
1113
1200, GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording fees: Deed $ 6.00 Mortgage $ Releases $ {;,OO
1202, City/county tax/stamps: Deed $ Mortgage $ I
1203, State tax/stamps: Deed $ 390.00 Mortgage $ ':!qn nn i
1204, RECORD CONTINUOUS MARRIAGE AFFIDAVIT 6.00 I
1205,
1300, ADDITIONAL SETTlEMENT CHARGES
1301, Survey to EVANS LAND ~III<Vt';Y 1\11, PO("
1302, Pest inspection to
1303, CITY OF CLEARWATER 5,00
1304
1305,
1400, TOTAL SETTlEMENT CH~IIGES (ent red on lines 103, sect/on J ana :JU2, section K) 6.00 4,876.00
CERTIFICATION: Ihave~efu~e!~ttl ~ Stateme~lIl;y knowledge and belief, Ills a Irue and accurale slalement of all receipts and ~rsemenls made on my account or by me In Ihls Iransaclion,llu:ther certlly
thall have rece~ 0.1 5 te~ " ,J/U,(Jl-(l / A
L/" __
bv: L .LTY U1"' I J M. V~.d.4.
Borrowers L..I Sellers VIVIENNE E. HAYI\lt<S
ave prepared is a lru"",nd accurale accounl of the lunds which were received and have been or will be disbursed by Ihe undersigned as part of Ihe seUlement 01 this transaclion,
OC'IDBER 1. 1991
Setll ent ent / Dale
SELLER'S A lOR PURCHASER'S STA TEMENT Seller's and Purchaser's slgnalure hereon acknowledges hisltheir approval 01 lax proralions and signifies Ihelr underslandlng Ihal prorallons were based on laxes for the preceding year, or estimates
lor the curren year, and in the evenl of any change lor Ihe currenl year, all necessary adjustmenls musl be made betwNn Seller and Purchaser; likewise any defaulf In dellnquentla.es will be reimbursed fo Title Company by the Seller,
Title Company, in its capacity as Escrow Agent, is and has been aulhorlzed 10 deposit all lunds it receives In Ihls Iransaclion In any Ilnanclallnstllulion, whelher allllialed or nol. Such IInanclal instllutlon may provide Title Company computer
accounling and audil services directly or through a separaleentlly which, II alllllaled with Title Company, may charge \lie IInanclallnstllullon reasonable and proper compensation Iherefore and retain any proflfs therelrom. Any escrow lees paid by any
parly involved in this Iransaclion shall only be lor checkwrlllng and Input 10 Ihe compulers, bul nol lor aforesaid accounllng and audll services, Tille Company shall nol be liable for any Inleresl or other charges on lho earnesl money and shall be under no
duty to invest or reinvestlunds held by It at any time, Sell s and Purchasers ereb acknowledge and consenllo \lie deposltollhe "crow money In Ilnaneiallnslllullons with which TItle Company has or may have olher banking relallonshlps and further
consent to the retenlion by Tille Company and lor Its a' les 01 an and al n s (Including dvantageous inlerest rales on loans) Title Company and/or its a\lillales may receive Irom SUjh I~a", I inslltullons by reason of their malnlenance 01 said
escrow acc(Junts. ..~,..... J....~_ '
The parties have read the ~'l ,rec ' it 5 rein ar rial, 0 same, and recognize Tille Compan~ is r~lylng on the am I 1 '
purchaser\j~,:ow"e Sellers ~ ,'1
WARNING: It is a crime to knowingly make lalse statements to the Unr
American Land Title Association Commitment, 1966
,
,\,==,
'CC"""=='="'=~==j,===-~=,~-,-='=I"'==='=='='='==='====""'"='====~=='='=""'~='=======""=-l-==============,'co"~
CbMMITMENT FOR TITLE INSURANCE
ISSUED BY 91080075
f_
STEWART TITLE
GUARANTY COMPANY
STEWART TITLE GUARANTY COMPANY, A Texas Corporation, herein called the Company,
for a valuable consideration, hereby commits to issue its policy or policies of title insurance, as
identified in Schedule A, in favor of the proposed Insured nallled in Schedule A, as owner or mortgagee
of the estate or interest covered hereby in the land described or referred to in Schedule A, upon pay-
ment of the premiums and charges therefor; all subject tq~heprovisions of Schedules A and B and to
the Conditions and Stipulations hereof.
This Commitment shall be effectiveOfHYWh~n thejd~ntity of the proposed Insured and the
amount of the policy or policiesc()rnrnittedforhaye~en, inser~ed in Schedule A hereof by the
Company, either at the time ofthei$$uance.of tlJiSCqrprpitment or by subsequent endorsement.
This Commitment is preliminarYt~.tN~i~~~~9~ef~~9,N.i.~~,lic:~i~r policies of title insurance and all
liability and obligations hereunder shall cease and terminatesixmonths after the effective date hereof
or when the policy or policies committed for shall issue, whic:p~ver first occurs, provided that the
failure to issue such policy or policies is not the fault of the Cornpany.
Signed under seal for the Company,.Ql.ltthis>Cdrnl)1itffl~t'ltshall not be valid or binding until it
bears an authorized Countersignature.
IN WITNESS WHEREOF, Stewart"T'ltl~9y~ral1~YGoropany has caused its corporate name and
seal to be hereunto affixed by its dulya\..itP9r:-ileqpfficElrsqnthe date shown in Schedule A.
STEWART TITLE
i/lIHfIIII'N~:s.
fjll"~\1.\-~,..F.!I,",4'. '.. ,".~'.
A. ...., ... =-..:
{Il+~J~9.P, O~~~~l
....:" -*-~: l!
1-' .... /Ii
'-"'\ 1908 /aJ
"- .-. .*. ..- ~'+'
'-.., , 7' ;-, .;....y...j..\ * #'
-~JI-,l;'
eJ~I/;7~
~~ '--ht~
GUARANTY (;OM,PA,NY
President
Company
City, State
I
ll=======,,====-~,===c.==
Serial No, C. 9 912.7 62 5 3 9
005N Rev, 3/78
..
mls
I
I
SCHEDULE A
Commitment No.
Effective Date of Com
91080075
Prepared For: CITY OF CLEARWATER, FLORIDA
Inquiries Should be Directed to:
MIKELL L. ST.GERMAIN
Stewart Title Company of Clearwater
1290 Court Street
Clearwater, Florida 34616
(813) 441-2689
1. Policy or Policies to be issued:
Amount
(a) 0 ALXA Owner's Policy
$
65,000.00
Proposed Insured:
CITY OF CLEARWATER, FLORIDA
(b) 0 AL TA Loan Policy
$
Proposed Insured:
2. The estate or interest in the land described or referred to in this Commitment and covered herein is a Fee Simple,
3. Title to said estate or interest in said land is at the effective date hereof vested in:
HARMOND M. HAYNES and VIVIENNE E. HAYNES, his wife
4 The land referred to in this Commitment is located in the County of PINELLAS
State of FLORIDA and described as follows:
Lot 1, Block "G", HIGHLAND TERRACE MANOR, according to the Plat
thereof, as recorded in Plat Book 36, Page 46 of the Public
Records of PINELLAS County, Florida.
Page 2
of 4
STEWART TITLE
2552
GUARANTY COMPANY
;.
I
SCHEDULE B
I ORDER NO:
,
91080075
C-9912-762539
Commitment Number:
I. The following are the requirements to be complied with:
1, Instruments necessary to create the estate or interest to be insured must be properly executed, delivered and duly filed for
record'a) Valid photo identification (ie: Driver's License, Passport)
and social security numbers required of all parties to the
transaction by the Insuror.
b) Proper Disposition of
AIKIA VIVIENNE E. BROWN
Public Records of PINE
against VIVIENNE HAYNES
in O.R. Book 5097, Page 344,
Florida.
II.
Schedule 8 of the policy or policies
of to the satisfaction of the Company:
Continued on next page
e issued will contain exceptions to the following matters unless the same are disposed
1, Defects, liens, encumbrances, adverse
attaching subsequent to the effective
estate orinterest or mortgage there
o matters, if any, created, first appearing in the public records or
ut prior to the date the proposed I nsu red acq u i res for val ue of record the
red by this Commitment.
2, Standard Exceptions:
(a) Rights or par iin ssession not shown by the public records,
asements, or claims of easements, not shown by the public records,
(c) Encroachments, overlaps, boundary line disputes, or other matters which would be disclosed by an accurate survey
and inspection of the premises,
, or a lien, for services, labor, or material hereto or h
IC r
(e) Rights of dower, homestead or other marital rights of the spouse, if any, of any individual insured,
(f) Any titles or rights asserted by anyone including but not limitedtopersons, corporations, governments or other entities,
to tide lands, or lands comprising the shores or bottoms of navigable rivers, lakes, bays, ocean or gulf, or lands beyond
the line of the harbor or bulkhead lines as established or changed by the United States Government or water rights, if any,
3, Special Exceptions:
(a) Taxes,
Subject to Taxes for the year 1991 and subsequent years, which
are not yet due and payable. Parcel No. 11/29/15/39258/007/0010
Gross Tax for the year 1990, $1,294.46.
4. Restrictive Covenants appearing in Deed Book 1533, Page 94 of
the Public Records of PINELLAS County, Florida.
5. Subject to easement twenty-five (25) feet wide over and across
the southerly boundary line for unknown usage as shown on plat
recorded in Plat Book 36, Page 46 of the Public Records of
PINELLAS County, Florida.
6. Subject to easement eight (8) feet wide over and across the
westerly boundary line for unknown usage as shown on plat
recorded in Plat Book 36, Page 46 of the Public Records of
PINELLAS County, Florida.
7. Subject to facts of survey by EVANS LAND SURVEYING, dated August
22, 1991 showing the CONCRETE HEADWALL encroaching into the
twenty five (25) foot easement over the southerly boundary; the
CONCRETE HEADWALL encroaching into the eight (8) foot easement
Continued on next page
2153
Page 3
of 4
STE'VAU,T TI'I'LE
GUARA;I;TY COMPANY
.
.'
I
I
CONTINUATION SHEET
Order Number:
SCHEDULE_
B
Commitment Number:
91080075
C-9912-762539
SCHEDULE B - PART I CONTINU
c) Continuous Marriage Aff"
VIVIENNE E. HAYNES to be
Pinellas County, Flori
HARMOND M. HAYNES and
the Public Records of
d) Satisfaction of that
and VIVIENNE E. HAYNES, his
PASCO COUNTY, filed October
6861, Page 987 in the prin
Public Records of PINEL
HARMOND M. HAYNES
vor of BARNETT BANK OF
9 in Official Record Book
amount of $52~000.00, of the
ounty, Florida.
e) Warranty Deed to
VIVIENNE E. HAYNES,
MOND M. HAYNES and
CLEARWATER, FLORIDA.
SCHEDULE B - PART II NTINUED
over the westerly boundary; and the STORM SEWER JUNCTION BOX
encroaching into Lot 1 and into adjacent Lot 2 from the eight
(8) foot easement.
Page_ 4 of 4
0055
STEWART TITLE
GUARANTY COMPANY
~
I
I
CONDITIONS AND STIPULATIONS
1. The term mortgage, when used herein, shall include deed of trust, trust deed, or
other security instrument.
2. If the proposed Insured has or acquires actual knowledge of any defect, lien,
encumbrance, adverse claim or other matter affecting the estate or interest or
mortgage thereon covered by this Commitment other than those shown in
Schedule B hereof, and shall fail to disclose such knowledge to the Company in
writing, the Company shall be relieved from liability for any loss or damage
resulting from any act of reliance hereon to the extent the Company is prejudiced
by failure to so disclose such knowledge. I f the proposed I nsured shall disclose such
knowledge to the Company, or if the Company otherwise acquires actual
knowledge of any such defect, lien, encumbrance, adverse claim or other matter,
the Company at its option may amend Schedule B of this Commitment
accordingly, but such amendment shall not relieve the Company from liability
previously incurred pursuant to paragraph 3 of these Conditions and Stipulations.
3. Liability of the Company under this Commitment shall be only to the named
proposed I nsured and such parties included under the definition of I nsured in the
form of policy or policies committed for and only for actual loss incurred in
reliance hereon in undertaking in good faith (a) to comply with the requirements
hereof, or (b) to eliminate exceptions shown in Schedule B, or (c) to acquire or
create the estate or interest or mortgage thereon covered by this Commitment. In
no event shall such liability exceed the amount stated in Schedule A for the policy
or policies committed for and such liability is subject to the insuring provisions and
the Conditions and Stipulations and the exclusions from coverage of the form of
policy or policies committed for in favor of the proposed Insured which are hereby
incorporated by reference and are made a part of this Commitment except as
expressly modified herein.
4. Any action or actions or rights of action that the proposed I nsured may have or
may bring against the Company arising out of the status of the title to the estate or
interest or the status of the mortgage thereon covered by this Commitment must
be based on and are subject to the provisions of this Commitment.
STE~ART TITLE
GUARANTY COMPANY
All notices required to be given the Company and any statement in writing required to
be furnished the Company shall be addressed to it at P.O. Box 2029, Houston, Texas
77252, and identify this commitment by its printed COMMITMENT SERIAL NUM-
BE R which appears on the bottom of the front of the first page of this commitment.
, ' .
I
I
00 -I
~
qJ~ -I n
~~ ':..I~' r- 0
m s:
~> '-'
,:;; z",S:
~~ l:! c
c: --- (1)0::;
g~ ~ ,-,
C" " cJJs:
~~ <
JJ m
~~ - :l>
~~ :2
:2 -I
~ n
~ m
Return 10: (enclose self.addressed stamped envelope)
I
WARRANTY DEED I
INDIVID, TO INDIVID,
Name:
Addr...:
91080075
STE!~~' ~ :;i;'~'; "~i~:':::.':',"/;';,:-,::;~1i.I~\,,: ~,~
By: -..Ml.KEL.L,J;;J~..,,?I~..~~N
129~.~ (,'ui'j:n ~~~te)~',;
CfctHiift-'I~'l;-~., ;':~, '.;':;~:ji_,:~
~. .0. t~.) :'1 !J'.3t'.
C1cl:l;~'I!I:,;. n. ]'l;.: 7
Wllkh Irl3lwm,l:I \1A'i.lrepoueti il1cidnHAi
10 wrilill~ of II Tille Insurllllc" Polky,
Properlv Appraisers Parcel Identification (Folio) Number(s):
This Instrument Prepared by:
Addr...:
Grantee[s! 5.5. '[51:
SPACE ABOVE THIS LINE FOR PROCESSING DATA
SPACE ABOVE THIS LINE FOR RECORDING DATA
m.lrfs lIIurrautu ittb Made the 1st day of October,
HARMOND M. HAYNES and VIVIENNE E. HAYNES, his wife
hereinafter called the grantor, to
CIIT OF CLEARWATER, FLORIDA
whose post office address is P.O. BOX 4748, CLEARWATER, FL. 34618
hereinafter called the grantee:
(Wh.rey.r uoed h.reln lb. ieI'm. .grantor. and ....n.... Includ. all lb. partl.. to Ibl. 'IISI.-um.nt ..nd lb.
h.ln, 1.11"1 r.pr...ntally.. and a..lgo. of individual.. and th. ..cc...on and a..lgo. of corporation.)
.itntlllld4: That the grantor, for and in consideration of the st/.m of $ 1.9.00 and other
valuable considerations, receipt whereof is hereby Mknowledged, hereby grants, bargains, sells, aliens, remises,
releases, conveys and confirms unto the grantee all that certain land situate in Pinellas
County, State of Florida , viz:
Lot 1, Block "G", HIGIll..AND TERRACE MANOR, according to the plat thereof, as
recorded in Plat Book 36, Page 46 of the Public Records of Pinellas County,
Florida.
A.D. 19 91
by
parcel number 11/29/15/39258/007/0010
Grantors social sec. 1I.51.'.-l9..__II/~ (HARMOND) 37f~5'~)-010~
(VIVIENNE)
mogtf4er. with all the tenements, hereditaments and appurtenances thereto belonging or in anywise
appertaining.
mO )taUt aub to )folb. the same in fee simple forever.
Anb the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee
simple; that the grantor has good right and lawful authority to sell and convey said land, and hereby warrants the
title to said land and will defend the same against the lawful claims of all persons whomsoever; and that sa1:d land
is fr;,e Of. all encUmb.rances, except ~l~i.:ffgW8gssu8flllg~&~~Becern~~t~~Jt[0'1~<ftd easements and
.nn itne.s.s 4treof. the satd grantor has stgned and sealed these presents the day and year first above
written.
Si ned, sealed and delivered in the presence oj:
\..J.JJ
.r\k(\...UVV\,~~ rtYJC/.- /(0 ^....~;~ j tl:-\r1" IJ..,1 tJ ~
Signature J" () . ~ ~
Prin~~~;!~ M. HA~~ -A ,/
I1l8 [d"lJj. rt. H ,uy'" UHa }..jti" H.,3 <f b 15 .-
05t Ice A rw.
,5'" t:7 ft1 e /' ,S'
/
- Vl1!t1 w;vtt.L--- ~,
Signature
;j~
t!D
Prin~~~~ E. HAYNES
11j~7tr; fn.....,,/a-C ,J.rtk-'r-'l.v-a:~Jv a~ iJ<fh/5'
Poot Olilc. Atcl.....
who executed the f()r~gojng instrument and they acknowledged before me that
WITNE~~my hand',aTld official seal in the County and State last afores .
STATE OF Florida
COUNTY OF Pinellas
I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State aforesaid and in the County aforesaid to take
acknowledgments, personally appeared HARMOND M. HAYNES and VIVIENNE E. HAYNES, his wife
hto me known to be the person S described in and
t ey executed the same,
, 1st d of Octobel! ,A,D, 19 91-
'//U&C
ot.i.tY0,gnature
, (( C 1/1 /J'~ /)
I'rinled Not:...y Signalll'"
My COlHlluE:pion Expil'eE::
',' '-,' /,"
SEAt'
E. ...S~ cJ /1--1 e' /" S
/ I -) -y C/
, (~
..rI
.cY;"""":~":"'-::~~ ,"'V . ?~<,,,?/ ~~:C:~4~/;t~,~....q I
~ PREPARED FOR: ~,271'~~ e''''/;:::= ae- '::;~':=-A~/V4.~~ ~t./C, SEC.
_-o'7'..0'l;..-:..-:-,,?,/.,- ,e",,/-/2"~ 6.c/.-4:~-;4::,t.'-C-E ?~4/,--q~er/Y
-~
o
t"
~
~,
\\
~
~
t:
// 1WP ..t':~.s: RGE ,'5E
- .- .-
." c::::' /C-~LE4 .,.?;,"7REET
? ",If- 1'" ""-
,
~~
(If
c
(-:...q..:::-,/;'~.y 6";3/_->)
..::J" c:7" ~ ~ ",,""? ' --;f c!? // E
.:::>7:7 '
N
(I' ::.-
/ c::::".::: c:bd '
1.'1 ",:"?-'~__ 5E/<~~
J JP"A/C T/.?-v 5V'.x'
? CJ'
E,<k;:R,;?""',<-#"~EA/ 7"
j
- ,
~
~
~
,
~ \
~ ~
~ ~
-:' . ~~
'. ~
.; ~
, \l
'.' "
, '>
I....
~
I .
~
~
~
~
~
\~
~
~
'~I
I IA/#)
1 ~cJr'
/ {} ;/ 6 ;.It!/'~'
j..; attl~ ,J/'.P
p ;vI/
;4.Jv/-
( /;Y1~ .
~
'\
~
~
~
,!)
~
\
\\
'\
~'
.\.
~
'I
1
I
I
L_______________________
~.5 . E..-<?5.E -*",':-.A:/ T
, .
~'
,'<
1\ ~ ,
~,
\:
"
;tirE
;p/t'lt?
I{}.1/'f
()
"~f
_-?J ' ,
I
fit (f.!J.t,)
..p~.:P~ ;/ ,..,.-/E~P)
f!/;.tg
t'1:7
..-t/ d -:7' G> .?"? ' ..,...4 c3' // /'t/
/uZ: /5'
~,# _ ~C'.?:::Ge:;.? C'~AYC'AP..c7'E 4?'P'.A/",:Y~E.A/T
//~ - ~~~V..::7 /~~A/ ,.q--~E
.3"/~ - '-=:>~"'- ..-;K"'~,(/ .-4"""""..,,;7
,1""~L . ,?7""",,4/,T;...</ La/E
3";'<-C. - _-7""",,"C .?'7~A/'
7?Y~ _i;:!:::?~...</5~/~
.-L?~ - A"".-4'.A/6E
A SURVEY OF L c:;1T // ..BL"..-::7,c/<", G, /~'6,.+~:A":,c._L? ,"2S'4""A'?4L:C- ,~/(/0~?
AS RECORDED IN PLAT BOOK ~ , PAGE ~ , OF THE PUBLIC RECORDS
OF PINElLAS COUNTY, FLORIDA
I HEREBY CERTIFY THAT THE SURVEY REPRESENTED HEREON MEETS THE MINIMUM
REQUIREMENTS OF CHAPTER 21 HH-6, OF THE FLORIDA ADMINISTRATIVE CODE.
EVANS LAND SURVEYING
(X.&/
DATE: ~~~ ':9/
~~~MAIN STREET - UNIT.h'
DUNEDIN, FLORIDA 34698 PH: 734 - 3821
L EVANS
. No. 2937
OWN. BY: j{;;,"'.8
INY. NO.:?/- #3
8~at~...4~ Y .:::f~~YE Y
I
I
NON-l"OmUCN CEH'l'U'ICJ\'I'lON BY INDIVJDU1\L 'l'H1\NSF'EHOn
1. Section 1445 of tile InLernal Hevenue Colle provides that a trcl\lsferee (If a United
States real property interest must withhold tax if the transferor is (j foreign person.
2. In on]eL' to inform the transferee that withholding of tax is not required upon the
clis[XJs.i.t.i.on by HARMOND M. HAYNES and VIVIENNE E. HAYNES
of the United Stat~s real property described as follows:
LOT 1, BLK "G" HIGHIAND TERRACE MANOR
the wldersigned transferor certifies and declares by means of this certification, the
following:
(a) I (We) am (are) not non-resident alien(s) for purposes of United Stales income
taxation ancl,
(b) My United States taypaper identifying Ilumber(s) (Social Security Number) is/are:
Nl\ME SOCI1\L SF.cURI'l"i NUMOER
HARMOND M. HAYNES
VIVIENNE E. HAYNES
It ~ 1'-? ~ .- I 2,-1116 ----
It.../ :~ 7r ,- :50 [} 70S
It
It
(c) ~1y home cl(lc1ress 1s
(a ttached mldi.tional page if necessary)
(cl) There are no other persons who have an ownership interest in the alJove-descd,t.ed
property other than those (~rsons set forth above in subparagraph (b).
). 'J11e undersigned hereby further certifies and declares:
(a) I (We) understand that the purchaser of the aoove described property intends
to rely on the foregoing representations in connection with the United States
Foreign Investment in Heal Property 'lux l\ct. (94 Statute 2602 as amended).
(b) I (wo) understnnd LIlis certification IIny be llisclosed to the Internal Hevenue
Serv.i.ce by transferee and that any false statement contained in this certification
I1Iny be pIli df,ihe(] by Hlle, J.lllpr.i.BOIlIIIGllt or lx:>l:h.
Under penalties of perjury I (we) declare I (we) have examined carefully this certi-
fica tion and it is tnJe, correct and comple te .
Date
OCTOBER 1, 1991
at
PINELLAS
County,
FLORIDA
/~-
Witness
(\.~~ ^.^"Lf'>-.J\ d · ~~ (1, 1 '111J
. / HARMOND M. HA'tNes ' ,
~VtJt.(cen-7~ t/ - 1kZ.w7~(j.
VIVIENNE E. HAYNE~
('111is doclunent must be retained W1til the end of the fifth taxable year following the.'
taxable year in which the transfer takes place).
CONSUIJl' YOUH l\'l'l'OnNr~Y l\ND/On 'l'1\X l\DVlSOH - NO REPHESeWl'J\'l'ION on RECOMl\1ENDJ\'l'lON IS Ml\DE DY
STeWl\ltl' 'l'l'l'LE INSUHl\NCg Ca1P1\NY 1\ND/on CONCEI~ING TilE
LEGl\lJ suni'JCIE:NCY 1\NIJ/on 'J'l\X CONSQUI!.'NCES OF' 'nlls DOCUI\1ENl'. YOU Ml\Y BE nEQUIIU~J) '1'0 FILE
1\ COPY OLi' TIlTS rxx.;UMP;N'J.' WITII '1'I11~ IN'l'ERNl\fJ \UWE:NUI~ S'~HV.tCE. '.I1mSE NU!: QUESl'lONS FOR YOUR
N1'l,()HNI~Y em '!'AX ADVISOR.
.' ,
"I"'
S'l'1\TE OF
COUN'l"i OF
FLORIDA
PINEILAS
I IIEHE:BY CEH'l'HY that on tlds day, before me, an officer duly authorized in the Slate
aforesaid and in the County aforesaid to take acknowledgments, personally nppeared
HARMOND M. HAYNES and VIVIENNE E. HAYNES
to me known to be the persons described in and who executed the foregoing instrument
and they acknowledged ~fo;r,e llIe that they executed the sallie.
WI'l'NESS my hand and6fficial: ,f?eal in the County and
of OCTOBER , 19 .91.
1 'day
-; --? F/'
J, BE FILLED IN PERSONALL~
BY SELLER OR BORROWER IN HIS OWN HANDWRITING
INDEMNITY AND AFFIDAVIT AS TO DEBTS, LIENS, AND POSSESSION
USE SEPARATE FORM FOR EACH PARTY
HARMOND M. HAYNES and VIVIENNE E. HAYNES
Seller or Owner-Borrower
wr 1, BLK "G" HIGHLAND TERRACE MANOR
Contractor (if new construction)
Purchaser
personally known to me to be the person whose name is subscribed hereto, and upon his oath deposes and says:
I, the seller, owner-borrower, and/or contractor, represent to the purchaser and/or lender in this transaction
that to my knowledge there are:
1. No unpaid debts for plumbing fixtures, water heaters, floor furnaces, air conditioners, radio or television an-
tennae, carpeting, rugs, lawn sprinkling systems, venetian blinds, window shades, draperies, electric appliances,
fences, street paving, or any personal property or fixtures that are located on the subject property described
above, and that no such items have been purchased on time payment contracts, and there are no security
interests on such property secured by a financing statement, security agreement or otherwise except the
following: one, so state.)
NAME ND DDRESS 0 SECURED PA TY Approximate Amount
/'
./
Approximate Amount
/
/
terial used in the const vements or repairs on the above described property
have for and there are now no unpaid labor or material claims against the improvements or the
property upon which same are situated, and I hereby declare that all sums of money due for the erection of
im vements or airs have been fully paid and satisfied, except: (If none, so state.)
NAME AND DRESS OF SUPP IER OF LABO~t CES 0 A TERIALS Approximate Amount
./
bts or liens of any kind other than those listed
Approximate Amount
S. I, the owner-borrower, or purchaser, have not been given notice of the furnishing or intent to furnish any labor,
services, or materials in connection with any improvements or repairs to said property from any person or firms,
except: (If none, so state.)
SUPPLIER OR LABOR, SERVICES OR MATERIALS ADDRESS
6. I, the undersigned owner, further certify th",t the real estate and personal property above described are in the
actual possession of the undersigned and is not in the possession, actual or constructive, of any person, persons,
or organizations holding or claiming same, adversely to the undersigned under contract, lease, or any other color
of title or right of possession.
The improvements or repairs to said property are now completed and have been accepted by purchaser and/or
owner-borrower.
INDEMNITY: I, THE SELLER, OWNER-BORROWER, AND/OR CONTRACTOR, AGREE TO PAY ON DEMAND
TO THE PURCHASERS AND/OR LENDER IN THIS TRANSACTION, THEIR SUCCESSORS AND ASSIGNS, ALL
AMOUNTS SECURED BY ANY AND ALL LIENS NOT SHOWN ABOVE, TOGETHER WITH ALL COSTS, LOSS
AND AITORNEY'S FEES THAT SAID PARTIES MAY INCUR IN CONNECTION WITH SUCH UNMENTIQNED
LIENS, PROVIDED SAID LIENS EITHER CURRENTLY APPLY TO SUBJECT PROPERTY, OR A PART THERE-
OF, OR ARE SUBSEQUENTLY ESTABLISHED AGAINST SAID PROPERTY AND ARE CREATED BY ME,
KNOWN TO ME OR HA VE AN INCEPTION DATE PRIOR TO THE CONSUMMATION OF THIS TRANSACTION.
I realize that the purchaser and/or lender in this transaction are relying on the representation contained herein in purchasing
same or lending money thereon and would not purchase same or lend money thereon unless said representations were made.
'~( ~vYl ~l,,^ rfJ .I 7J? i}!CU!-MI
hi, HARMOND, M. HA, YNES, / ", "
~o_ 8:,. ~d' , "
SWORW E uWS~~ED BEFORE ME THIS 1
day of
OCCYI'BER
, 19-2L.
County,
My Commission Expires:/'1 (~ ')-
FLORIDA
Rev, 1/88
NOTE: Thu form is to be signed by seller in cue of ..le. If no uk, it is to be .iped by the owncr~borrower, If there ilany new construction, .he contrKlor mUI' allo join in thit form
or sian a separate one.
I
I
."'a",.,;/r III ('OllffUt"l
RONALD (RON) E, SOMERS
President
STEWAI~T TI~"'J.....I~
OF CLEARWATER
p,o, Box 2756
Clearwater, Florida 34617
(813) 441,2689
1290 Court Street
Clearwater, Florida 34616
D I S C LOS U R E
We, the Owners of that certain real property located at
LCYI' 1, BLK "G" HIGHLAND TERRACE MANOR
li
Pinellas County, Florida, do hereby disclose the follo"\'ling facts
known to me which may materially
of said propertyCCt1 ~ /
I HEREBY CERTIFY that I have
affect the value
'~ "'1:Y'
no k:2siedge of
or desirability
any facts or
defects in said property which may materially effect the value or
desirability of said property, except as set forth above. I
acknowledge that this disclosure will be given to the listing
broker, the selling broker, and any prospective buyer.
/~
' )\0 u....J
Wi tne s )
/~
' Wftrle s
~ "I.^--vVI'~~ I ,-yv1 If'}-l atl-'l[U
. J
HARIDND M. HAYNES
,I
./ ~1./M?U1L {{:- ~
VIVIENNE E. HAYNES
STATE OF
FLORIDA
COUNTY OF
PINELLAS
SWORN TO AND SUBSCRIBED BEFORE ME THIS
1
DAY OF
OCTOBER
, 19 91
,/
~
My Commission Expires: ~
11- ')~9~
:( ..,'
! If:")
-I C"'I/
,'I
.
L.) '; ,
/
. ( p ,~.....
I,) ".,'
(i
"
~' j
. .,'
ri II'
I
I
INFORMATION FOR REAL ESTATE 1099-S REPORT FILING
Section 6045 of the Internal Revenue Code~ as amended by the Tax
Reform Act of 1986, requires the 'reporting of certain information on
every real estate transaction. From the information you provide
below, a Form 1099-S will be produced, a copy of it will be furnished
to the I.R.S. and to you no later than January 31 of the next year,
and a copy may be sent to other third parties. If you fail to furnish
adequate information (in particular, a taxpayer ID number), then you
will be subject to all I.R.S. Regulations, including the possible
withholding of twenty percent (20%) of the current sales price.
F . I N b 91080075
1 e urn er:
Taxpayer 10 Number: Seller 1 /.5'f3 -/.2,-///5 - Seller 2/3 ~f-~O-&7CJ.5
Taxpayer ID Type:
2
~1 = business, 2 = individual)
Last:
SELLER 1 NAME:
HAYNES
First & Middle:
HARMOND M.
SELLER 2 NAME:
ii
Last:
HAYNES
First & Middle:
VIVIENNE E.
MA~ ADDRESS (as of January 31 of next year)
SELLER 1:~ -
Stree~c,. ~"Y; e.- /~ -J--"t(<M{,-nl1
C1t~ ' s~:l~of<Jt,
Z~de: 3C{6 {j
SELLER 2:
Street:
City:
State:
Zip Code:
TRANSACTION INFORMATION
Closing Date (MMDDYY):
OCIDBER 1, 1991
Contract Sales Price: Seller 1 -
65,000.00
Seller 2 -
(If multiple sellers please allocate the sales price among the sellers)
Description of Property:
Street Address:
1314 N. HIGHLAND AVENUE, CLEARWATER, FL 34615
Legal Description:
Lor 1, BLK "G" HIGHLAND TERRACE MANOR
Under penalties of perjury, I,
HARMOND M. HAYNES and VIVIENNE E. HAYNES
(Name of Seller (s))
certify that the number shown on this form is my correct Taxpayer
Identification Number and that the other information is correct to the
best of my understanding and I understand that it will appear on a Form
1099-S that will be sent to me and to the Internal Revenue Service.
Date: /fllt/
Date: / /~j. iff'J
CLOSING AGENT
HA'mES
Seller - 1 Signature~
Seller - 2 Signature:
Name:
STEWART TITLE COMPANY OF CLEARWATER, INC.
Mailing Address:
1290 COURT STREET
City:
CLEARWATER
State:
FL
Zip Code:
34616
Taxpayer ID Number:
59-1433918
" ~
i
."~~
I
I
\'",,1'1;1. III (.'Illlflnt"
RONALD (RONI E, SOMERS
President
1290 Court Street
Clearwater, Florida 34616
s'r]~'VAIl'r 'rrrL]~
Of CLEARWATER
P,O, Box 2756
Clearwater, Florida 34617
18131 441-2689
AtJI110RIZATION AND ACKNOWLEDGEMENT FORM
Reference:
FILE NO.
91080075
LEGAL
rm 1, BLK "G" HIGHLAND TERRACE MANOR
SElLER
HARMOND M. HAYNES and VIVI.f:NNE E. HAYNES
.'
BUYER
CITY OF CLEARWATER
We hereby approve and acknowledge receipt of a copy of the Statement and actual
cost (DISCLOSURE/SETTLEMENT STATEMEN'r - HUn FORM 1) and authorized disbursement
of funds as shown therein this 1 day of OCTOBER-- , 19 91. We further
acknowledge that we understand utility bills are not included in this statement
and that the proration of taxes as shown in the statement of actual cost is
based on the latest infonnation available. If any changes are to be made in this
proration when the tax bill is received, it will be handled between the parties of
this transaction. Stewart 'ri tIe Company of Clearwater, Inc., will not be held
responsible. It is further understood that Stewart Title Company of Clearwater,
Inc., cannot, at this tinle, assertain if there will be personal property tax on
subject property or an amount on which to base a proration. Any proration necessary
when tax bills become available will be handled between the parties to this
transaction, outside of Stewart Title Conlpany Company of Clearwater, Inc.
Stewart Title Company of Clearwater, Inc., will be not held responsible.
'!HAT ALL Ul'ILITY BILLS (WATER, SEl'lm, ~C,
OR WIIL BE PAID ~ REX::EIPr OF FINAL BILLS.
~V14~ €,/ ~<ftiJ.
"~~d, '1L' /0-;p~ 'f-{<tif-nJ1
,~ARMOND ' . HAYNhl;
V' V,' V /t It Iv' ~ J;;:- 'fLi 11 eA-
VIVIENNE E. HAYNES
~ FEES) HAVE BEEN PAID
~' /~II
~~~~md;~
SEILER I S FORWARDING ADDRESS:
1f/180~ U
ItAce/ULI, diu" FL ,,~6 16
Ha1E PHONE1t 818- c:f<p3 .. cJ .s '3 '- J
WORK PHONE#~8 '-~cf_1- ~ (j; 6 /
BUYER I S FORWARDING ADDRESS:
/
PD. ~ +71R
{JQl~~ - rl 3{b(j
I
".....
/y / WORK
THIS IS TO FUR1UER AU'llIORlZE ~ / It-
GlANGES NECESSARY TO THE CLOSING STATE1'1EN'r. (
HCX'1E PHONE#
PHONE# /
{6~-~1~
TO APPROVE ANY
S1'E.WARr TITLE COMPANY OF CLEARWATER, INC.
'~
"," ,",'" (l d
By:Y10 .', .;f~ffZ!;-L//IW,