WALTER NATTIEL JR
"
WARRANTY DEED
INCOIVIO. TO INOIVIO
I I
This ~arrantg Jeed !vlade the f~ day of April A. D. 19 87 by
ANNIE E. WILSON, formerly known as ANNIE ELIZABETH SANCHEZ, and also
known as ANNIE ELIZABETH WILSON, joined by her husband, ADOLPH WILSOr
RAMeo FORM 01
hereinafter called the grantor. to
CITY OF CLEARWATER
whose postoffice address is P.O. Box 4748, Clearwater, Florida 33518
hereinafter called the grantee:
(Wherever used hpre.in tht' terms iO~ranlUrn and '4~ranlee" include ail the parties to this instrument and
the hei.., le"al repre,entati"es and a..i"ns 01 individuals, and the successors and a>signs 01 corporations)
~itnessdh: That till> grantor, for and in consideration of the sum of $ and other
valuahle considerations, receipt whereof is hereby acknowll!rlgecl, hereby grants, bargains, sells, aliens, re-
mises, releases, conveys and confirms unto the grantee. all that certain laud situate in
County, Florida. vi:z:
Lots 12 and 13 of the JANIE DANIELS SUBDIVISION, according
to the map or plat thereof as recorded in Plat Book 5, Page
23 of the Public Records of Pinellas County, Florida
Together Wit/l all the tenements, hereditaments and appurtenance. thereto belonging or in any-
wise appertaining.
ID Ilaue and to 1lD1d, the same in fee simple forever.
Rnd the grantor hereby covenants with said grantee that the grantor is lawfully sei:r.ed ;f said land
in fee simple; that the grantor ha.s good right and lawful authority to sell and convey said land; that the
grantor hereby fully warrants the title to said land and will defend the same against the lawful claims 01
all persons whomsoever; and that .aid land is free of all encumbrances. except taxes accruing subsequent
to December 31, 19 86
IB ~ibtess 1tJhtreDf, the said grantor ha.s signed and sealed these presents the day and year
first above written. SEE REVERSE SIDE FOR ADDITIONAL SIGNATURE AND NOTARY
~~~:"...:. I\~~~;~~..........................................:
STATE OF NEW YORK
COUNTY OF ROCKLAND
!
SPACE IELOW POI IECOIDElS USE
I HEREBY CERTIFY tbat on this day, Mfore me, an officer duly
autborized in Ibe State aforesaid and in tbe County aforesaid to take
acknowledgmenu, penonally appeared
ADOLPH WILSON
to me known to be the ptrson descriMd in and wbo executed the
foregoing instrument and he acknowledged before me tbat he
c~ecuted tbe same.
" : r:,' " ";;i"i';:-C''\) WITNESS my hand and official seal in the County and
FFiAIX r.;."" ii, I:: ' :,' State last aforesaid tbis day of
Notary Pu c, St~te GIIi<';"'1 York A" I ., _ A D I ,>J. 7
, ~"77'"" prl. ~ , . . 'I/J
No. IB",4o~ ';i;)
co~~!~~~d ~~~e~~~~.c;~.n~~9?,~.......~...~......",..,
This Ins/rumen' prepared by: David M. Wall, Esq.
Add. 2420 Enterprise Road, Suite 204
ms Clearwater. FL 33575 ~ ~~ cUv.
delivered in
Signed,
'our p
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 afore-
said to take acknowledgments, personally appeared ANNIE E. WILSON
to me known to be the person described in and who executed the
foregoing instrument and she acknowledged before me that she ex-
ec uted the same.
WITNESS my hand and official seal in the County and State
last aforesaid this
8th
day of
AP~~
N ARY PUBLI ~
MY COMMISSION EXPIRES :/J-;1 -? CJ
.',1' .:+
_,\\\\" , It f ,~',
;' \. ( \, . . .' ,..,
;' ~
, fl~;' ~!.
;~';;'.,"r
..~',L., ' "-,, 1-,...
. "
~'r I
.....#' "
~
,-1 !'.
~. .......al ~ i., ',I . ....... . \
..' ) );. ,:,'.
~.'. -","",::, ,"~' i,." t.";'/
v'} '.':, I,:. .1'" ... ,'.
~ l,t . 1;1,..':. ~ J,.,.\ ...,..
I I, ,':" ~, : i.) , "1
,:'~4;'''''\'' ,i
~
~
~
~
=
.......
-=
n
i:
~
~
~
=--
:u
,.
3:
n
o
'"
o
:u
3:
o
~
I""' IJ... r .......&;;..., .... r&;;.nW'''"'..._...... I U I ~r;;....,-r;;.n ""'" u,,",""v.. r;;.n ... . n I"~ ""' ....... .- ......
SUBJI:CT PROPERTY:
STATE OF FLORIDA, COUNTY OF
INDEMNITY AND AFFIDAVIT AS TO DEBTS AND LIENS
wrs 12, and 13, JANIE DANIELS SUBDIV~ION
ANNIE E. WILSON
FI~TTZ\S
BEFORE ME, the undersigned authority, on this day personally appeared
Seller or Owner-Borrower
Contractor (if new construction)
CITY OF CLEARWATER
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:
I. No unpaid debts for plumbing fixtures. water heaters, floor furnaces, air conditioners, radio or television an-
tennae, carpeting, rugs, lawn sprinkling systems, venetian blinds, window shades, draperies, electric appliances,
fences, street paving, or any personal property or fixtures that are located on the subject property described
above, and that no such items have been purchased on time payment contracts, and there are no security
interests on such property secured by a financing statement, security agreement or otherwise except the
following: (If none, so state.)
NAME AND ADDRESS OF SECURED PARTY Approximate Amount
1 . Zi
~/ ~. }1/ .hL/
2. No loans of any kind on said property except the foJlowing: (If none, so state.)
NAME AND ADDRESS OF CREDITOR
71 tn-L-I' -
Approximate Amount
')1
L7'7A-iI ./
fl,
{~../ ~
'}rJ.~~
3. All labor and material used in the construction of improvements or repairs on the above described property
have been paid for and there are now no unpaid labor or material claims against the improvements or the
property upon which same are situated, and I hereby declare that all sums of money due for the erection of
improvements or repairs have been fully paid and satisfied, except: (If none, so state.)
NAME AND ADDRESS OF SUPPLIER OF LABOR, SERVICES OR MATERIALS Approximate Amount
"9- . tl - '
CVJ-~. ~, YlJ:f/.J;J.U
7(G'J.,{..k' ./
4. I, the purchaser, represent that I have no knowledge of any debts or liens of any kind other than those listed
above, except: (If none, so state.)
NAME AND ADDRESS OF SECURED PARTY, CREDITOR. SUPPLIER gJ:
LABOR OR MA TERIALS ~ Approximate Amount
MINt..
5. I, the owner-borrower, or purchaser, have not been given notice of the furnishing or intent to furnish any labor,
services, or materials in connection with any improvem7nts or epairs to said property from any person or firms,
except: (If none, so state.)
SUPPLIER OR LABOR. SERVICES OR MATERIALS ADDRESS
NONL- .
6. I, the undersigned owner, further certify that 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, ANO/01{ CONTRACTOR, AGREE TO PA YON DtMAND
TO THE PURCHASERS AND/OR LENDER IN THIS TRANSACTION, I HEIR SUCCESSORS ANDASSIGNS, ALL
AMOUNTS SECURED BY ANY AND ALL LIENS NOT SHOWN ABOVE. TOGETHER WITH ALL COSTS, LOSS
AND ATTORNEY'S FEES THAT SAID PARTIES MAY INCUR IN CONNECTION WITH SUCH UNMENTIQNED
LIENS, PROVIDED SAID LIENS EITHER CURRENTLY APPL Y 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.
~-,-
"': '
SW, ORN TO AN~IBE~" BEE1F =15 ,', 8th :d~Y'af APRIL . 19~,
My' Commission Expires: ,/1 -- .) -9 0
Notary Pub1\t in and for PINELLAS County, FLORIDA
Rev. 3/80
NOTE: This form is to be ~igntd by seller in case of sale. If lit. ...ale. il l!l. hI he signed "'~:.hC' ~I~~~r.,ht\frn..er, If there is an~' new conslruction. the contractor ,mUSI also .loin 10 this form
or sign a separale one.
,~
I
I
NON-FOREIGN CERTIFICATION BY INOIVIDUAl TRANSFEROR
1. Section 1445 of the Internal Revenue Code provides that a transferee of a Uni ted
States real property interest must withhold tax if the transferor is a foreign person.
2. In order to infonn the transferee that withholding of tax is not required upon the
disposi tion by ANNIE E. WILSON
of the United States real property described as follows:
LOTS 12 and 13, JANIE DANIELS SUBDIVISION
the'undersigned transferor certifies and declares by Dleans of this certification, the
following: ..
(~) I (We) am (are) not non-resident alien(s) for purposes of United States income
taxation and, '
(b) My United States taxpayer identifying number(s) (Social Security Number) is/are:
NAME SOCIAL SECURITY NUMBER
ANNIE E. WILSCN , ,/ "" d6$' - ~l>... 9;1,;< 9
,
,
,
(c) My home address is 6/~1) .ilb-r.J.. ~. S. AI ~ ~ ,fJ, 337/
(attached add1 t10nal page if necessary) . ~ y . .. . 2.-
(d) There are no other persons who have an ownership interest in the above-described
property other than those persons set forth above in subparagraph (b).
3. The undersig~d hereby further certifies and declares:
(a) I (We) understand that the purchaser of the above described property intends
to rely on the foregoing representations in connection with the United States
Foreign Investment in Real Property Tax Act. (94 Statute 2682 as amended).
(b) I (We) understand this certification lIIay be disclosed to the Internal Revenuf>
Service by transferee and that any false statelllenl contdined in this cel"tificdtill/
may be punished by fine, imprisoruent or both.
Under penalties of perjury I (we) declare I (we) have examined carefully this certi-
fication and it is true, correct and complete. '
-
at
PTNF.T.T .A.!=:
, _,_Coun~, - rtlT:;
/~t-,,~~. /6. W', tt' .'
E E. WILSON ' '
Wltness
(This document must be retained unti I the end of the fi fth tdxdble ,yedr fullowiny the
taxable year in which the transfer takes place).
CONSUL T YOUR ATTORNEY AND/OR TAX ADVISOR - NO H(PH(S[NTATION ()I~ 1~(COMMENDATlON IS MADE BY
STEWART TITLE INSURANCE COMPANY AND/OR CONCERNING HIE
LEGAL SUFFICIENCY AND/OR TAX CONSQUENcrS' orlills"oOCUMCNr:- - 'YOl.f ~,AYBE REQUIRED TO FILE
A COpy OF nus DOCUMENT WITH THE INT[I~NI\l HEV[NUE SERVICE. T1IE5[ ARE QUESTIONS FOR YOUR
ATTORNEY OR TAX ADVISOR.
STATE OF FWRIDA
COUNTY OF PINELLAS
I HEREBY CERTIFY that on this daYt before met clll offh;l~l' duly cluthorized in the State
aforesaid and in the County aforesaid to take adnowledYIII(!lIts, personally appeared
ANNTF. F. WTT .C;(N "'. . __ _,_... .' _ . ___ _ _ ." . "_ __ .'_" _,__
to me known to be the persons descri bed in and who execu t.NI the forego i ng ins truni"en-t-
and they acknowl edged before Ale tha t they execu ted the sallie.
WITNESS my hand and official ~eat i~ the Cuunty and State last aforesaid this ~th_ day
of APRIL ,19!D~' ",'~.-' ~.~
- ,.: - .' . ..... -:,. ", ~ / #' .s:o
... '.': :':. /~H_~~~
. . No ta ry ubllc--'
. '. " My COlllllli 5S i on Expi res: /'/ - J - i?'e;:?
..,..~~ .
:',
.,.. ,
'~':';,?-"r..,:;. .
~...--' ,."
,"':"'1,':':'
~",..(.
j,..~;~