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JOANNE DIXON MURRAY & CHARLES DIXON _ l...,. .. ,If-addrftSS9d stnmped envelop>;:) INST I 91-342282 . J DEe :I.B~ :I. 991 L:N~G.t.}:~~~'j 91060110 :~:~ ~5 I:? I __"___"n_~_____ F' I i\i I::: L L. f', ~~~ CDU I\'! T Y OFF.REC.BK 7762 PG FL.h. .6,ddfG$S: ~ ~ , j: ,. Th,k IllJt:'~~Je~t w~s .;.'re:;Jllre(~ by:. Jj SfE\\r\IU q,LL Ok ctEAI<v\'A.'f;(:1 ~ ~ ~.\", 1\ \~ Ii:.: Mikell..1~~!~ge0E_ai,1 v' l)':\W v ~ i29"~ COur~ S1n:\2~ ~ l,--^-", ~ .Ii Cic~r~1sler~ rt 3~~i6 ~ P.O, n1~X 7.756 ... C1~..m:ilf,'r, F'_" .'14617 t Vll'lJr.h !n~t:unu..:H~ wa~ prr.-,par~d rnddt:ntal -s to writing of R Titie Im,Uf&fiCe rolic}'. .~ ~ y This Instrument Prepared by: Plc-perty Appraisers Parcel Identification (Folio) Number(s): Grantee[s) 5.S, #lsI: SPACE ABOVE THIS LINE FOR PROCESSING DATA SPACE ABOVE THIS LINE FOR RECORDING DATA ___ J 7 TJ1 mItis marrnntu ileeb Made the day of December, A.D, 19 91 try JOANNE DIXON MURRAY, a 5/~j/-e-- woman and CHARLES DIXON, a single man hereinafter called the grantor, to CITY OF CLEARWATER, FLORIDA whose post office address is P.O. Box 4748, Clearwater, Florida 34617-4748 I I hereinafter called the grantee: (Wherever used herein the termJ. "gtoantor" and "grantee" inelude all th~ partiea to this ini:trumellt 'J.lld the heirs, legal represeutative. and u8ign. or Individual., and t.he IUeee8l0n and ulign; of eorporaUo:tg) lIitUts.adJy: That the grantor, for and in consideration of the sum of $ 10.00 and other va,luu.ble considerations, receipt whereofis hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys a,nd confirms unto the grantee all that certain land situate in Pine11as County, State of Florida , viz: Lots 8, 9 and 11 less south 50 ft. for street, Block 2, MOASE AND HARRISON'S SUB, PH H-2, Pg. 85, Pinel1as County, Florida. ALSO DESCRIBED AS: " /less Lots 8, 9 and 11 South 50 ft. for street, Block 2, MOASE AND HARRISON'S SUBDIVISION of Lot 7 of R.H. PADGETT'S SUBDIVISION, according to the Plat thereof, as recorded in Plat Book 2, Page 85 of the Public Records of Hi1lsborough County, Florida of whichPinellas County was formerly a part. ! ,:~ ) ; 1 / ~j I -' parcel no. 15/29/15/58338/002/0080 Grantors social sec. II;? h:J... ~~ -SS5lP (JOANNEL2t,3- 0{) - 5072- - (CHARLES) Property is not the principal residence of the Grantor~ she in fact resides at: ~()II/J:i d~. ,,51-.$-#noLvjt FI 357// _(JOANNE) Il REec/rIgs" ...EC u) S 1;)0 Documentary Tax Pd. $_" / a n o..J $ In!:;I''JIf,I'l Tax Pd, !~~'t ---- ;1~l~S By Deputy Clerk MTF --~ 'Ie --- KE''; -.----- r T~.AIJ 30 sVj ~9182.17b Ul - MErDRn j Nf.: ~ ,,1.,.--.,- DOC '2T Ar~PS .~ ;", /", i- ; 1 ~""i: '-=.'\0., .;...:.. i . ../~~;.~ =~-~ECt,:,. AM-.' ~ -:-:N:,[G;.E=~ ~ l"l,W ,1 ~ !t:C"':" KARLI:::EN F. DEBL.AKER, CLERK F'I:: r: q f::! X', I.) I:: f~! 'f'I:' .," -::')" Y; '.' ,. ~ ,......\..1,. ... ,_. ..1.....1 1:31. C-/\7 /2--- /""Jj v-r)o.. _ (/c ~f I I I ({~ .' k..' ... .~~ . i I PINELLAS COUNTY FLA. OFF.REC.BK 7762 ~G 260 y mogd4n. with all the tenements, hereditaments and appurtenances thereto belonging or in anyw1:se appertaining. mO lhtUf nub to )folb. the same l:n fee simple forever. 1\Ubthe grantor hereby covenants with sa1:d grantee that the grantor l:S lawfully seized of said land infee simple; that the grantor has good right and lawful a.uthority to sell and convey said land, and hereby warrants the title to said la.nd and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances, except taxes accruing subsequent to December 91, 19 91, ,and all easements and restrictions of record. IN WITNESS WHEREOF, the said grantor has signed and sealed these presents the day and year first above written Signed, sealed and delivered in the presence of: liD PrlnJ~= DTXON M(JRRAY ?P.~... ~ s~~t~~;~ P J 3:)'11 ) Printed Slpalure 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 ofol'csaid to take acknowledgments, personally appeared JOANNE DIXON MURRAY, a S I '1J )e-- woman to me known to be the person described in and who executed the foregoing instrument and she acknowledged before me that she executed the same. WITNESS my hand and official seal in the County and Stat last resaid this 11-t/1\ da of December . A.D. 19 91 / . t. ' , v '. ~~ ,~~ ' ..". SEAL 10 J~ . ..... ./ -.;.,. C fi W7JL 91plure b ( .~L ( 01/( flD \ ". CHART ,ES DTXON Printed Sl~ c./O I 4~~~ .~ ~I.~ ."...... ..... s+ - p,~"",-,,'Y F' 3, ~') \ \ 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 CHARLES DIXON, a single man to me known to be the person described in and who executed the foregoing instrument and he acknowledged before me th,t he executed the same. WI1NESS my hand and official seal in the County and State last aforesajq this / 1-t"",; day of December A.D. 19 91 .i ,I j. ..,:/ J-l l .' YJ}/:.I!!JJ(JI- ;'J.i/It /1./7 !/uiu ntl~Uj L L. cEJT (,E p-m A'/U ~ri'nW Notary Sig;,alure Y My Comn.ooio" E xpi reo: Cl':J. L/ c; ~ SEAL " '../ ./ ,":' ~ I 1 RONALD (RON) E. SOMERS President 1290 Court Street Clearwater, Florida 34616 .'\"".'t;t.. Ilf Coni""'! S'rEWAR'r "l"rrLE OF CLEARWATER P.O. Box 2756 Clearwater, Florida 34617 (813)441.2689 AUTHORIZATION AND ACKNCMLEDGEMENT FORM Reference: FILE NO. 91060110 LEGAL LarS 8, 9 and 11, LESS S 50 I FOR STREET, ELK 2, SELLER JOANNE DIXON MURRAY OOASE & HARRISON SUB BUYER CITY OF CLEARWATER, FLORIDA We hereby approve and acknowledge receipt of a copy of the Statement and actual cost (DISCLOSURE/SETrLEMENT STATEMENT - HUD FORM 1) and authorized disbursement of funds as shown therein this 17 day of DECEMBER , 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 information available. If any changes are to be made in this proration when the tax bill is received, it will be handled between the parties of this transaction. Stewart Title Company of Clearwater, Inc., will not be held responsible. It is further understood that Stewart Title Company of Clearwater, Inc., cannot, at this time, assertain if there will be personal property tax on subject property or an amount on which to base a proration. Any proration necessary when tax bills become available will be hm1dled between the parties to this transaction, outside of Stewart Title COITlpany Company of Clearwater, Inc. Stewart Title Company of Clearwater, Inc., will be not held responsible. '!HAT AIL UITLI'lY BllLS (WATm, ~, ELEX:'IRIC, OR WIIL BE PAID uroN ROCEIPl' OF FINAL BllLS. ~-"-) MAlNI'EIWn: FEES) Pk?- HAVE BEEN PAID INITIALS SELLER'S FORWARDING ADDRESS: 'tf/ C:;3C~ ~j~G, sl-fl4,.,L 7 " F/_ '::3 7/,- HCX'1E PHONE# <. 22z- J J 7..s WORK PHONE# /V #- BUYER'S FORWARDING ADDRESS: HCl1E PHONE# WORK PHONE# THIS IS TO FURTHER AUTHORIZE CHANGES NECESSARY TO THE CLOSING STATEMENT. TO APPROVE.ANY STEWART TITLE COMPANY OF CLEARWATER, INC. I ' BY'YAl ido;l41"lJ7kl? .~. TCI BE FILLED IN PERSONALL vi BY SELLER OR BORROWER IN HIS OWN HANDWRITING INDEMNITY AND AFFIDAVIT AS TO DEBTS,L1ENS, AND POSSESSION USE SEPARATE FORM FOR EACH PARTY JOANNE DIXON MURRAY Seller or Owner-Borrower LOTS 8/9 and 11, LESS S 50 I FOR STREET, BLK 2, MOASE & HARRISON SUB 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 fmancing statement, security agreement or otherwise except the following: (If none, so state.) NAME AND ADDRESS OF SECURED PARTY ~~() Approximate Amount . 2. No loans of any kind on said property except the following: NAME AND ADDRESS OF CREDITOR Approximate Amount 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 ~'Jl-RIALS Appro_.', Amouo. At,A~ & 4. I, the purchaser, represent that I have no knowledge of any debts or liens of any kind other than those listed above, except: (If none, so state.) NAME AND ADDRESS OF SECURED PARTY, CREDITOR, SUPPLIER OF LABOR OR MATERIALS Approximate Amount 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 thto.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 A ITORNEY'S FEES THAT SAID PARTIES MAY INCUR IN CONNECTION WITH SUCH UNMENTIQNED LIENS, PROVIDED SAID LIENS EITHER CURRENTLY APPLY TO SUBJECT PROPERTY, OR A PART THERE- OF, OR ARE SUBSEQUENTLY ESTABLISHED AGAINST SAID PROPERTY AND ARE CREATED BY ME, KNOWN TO ME OR HAVE AN INCEPTION DATE PRIOR TO THE CONSUMMATION OF THIS TRANSACTION. hase same or lend money thereon unless said representations were made, SWORN TO AND SUBSCRIBED BEFORE ME THIS I day of DECEMBER 91 ,19_. PINELIAS County, FLORIDA My Commission EXPirf~Y-,,9~ Rev. 1/88 NOTE: Thas form is to be signed by seller in case of ule. Uno u&e, it is to be aipd by the owner-borrower. If there lJ any new con.truction. the contractor mUll alia join in this (orm or si.n a sepanllc one I I S",,,'/il.y of ('Oll/rllrt RONALD (RON) E. SOMERS President 1290 Cou rt Street Clearwater, Florida 34616 STEWART TITLE OF CLEARWATER P.O. Box 2756 Clearwater, Florida 34617 (813) 441-2689 D I S C LOS U R E We, the Owners of that certain real property located at LOTS 8,9 and 11, LESS S 50 I FOR STREET, BLK 2, MOASE & HARRISON SUB Pinellas County, Florida, do hereby disclose the following facts known to me which may materially affect the value or desirability of said property. I HEREBY CERTIFY that I have no knowledge of any facts or defects in said property which may materially effect the value or desirability of said property, except as set forth above. I acknowledge that this disclosure will be given to the listing broker, the selling broker, and any prospective buyer. ~./)~4/~~m~) W. ness STATE OF FLORIDA COUNTY OF PINELLAS SWORN TO AND SUBSCRIBED BEFORE ME THIS /7tb DAY OF DECEMBER ,19 91 0.;)//- /jd My Commission Expires: 'l I . I I NON-fOIUUGN CEH'l'H'lCNl'.LON BY INIJ1VIlJUM, 'l'HJ\NSFEHOH 1. Sectlon 1445 or the' Internal He venue Ccxle provides that n trd\lsfet-ee c;.f a United States real pt'operty interest must withhold tax if the transferor is 1J foreigll 1)(3rsoll. In onlet" to 111(01;111 Lhe transferee Lhat wiLhho.ldlllV or Lox 1s 1I0t required upon Lhe tl.lspos.l.t.l.olI hy JOANNE DIXON MURRAY 2. of the United StoLes reill property uoscdbeu os [ollows: LarS 8, 9 and 11, LESS S 50' FOR Sl'REEI', BLK 2, MOASE & HARRISON SUB Lhe ullllersigne<l transferor certifies and declares by means of this certification, the following: (a) I (We) am (are) not Hon-resident al1en{s) (or (XJrposes of United Stotes income taxa Lion ond, (b) My Ullil c.(] States taypape.r identifying 1l1lIllber{S) (Social Security NWlloor) is/ore: N1\MB SOCI1\L S~"'CUlU'l"i NtJlllUEtt JOANNE DIXON MURRAY II ~ ~:1- .n - ~S-3 ~ II II " (c) ~1y homE! oddrco9 1s (attached otldJU.ollal l~ye .i.r lIecessary) (d) There ore no oLhel: lJOt:S01l9 who hav13 Oil OWII13J:shJp Jllterest ill tlte oIXJve-descd.bed property oLlll)r L1mll UIOS13 1)(3);50IlS set forth obove ill sub[Xlt:flgroph (l>). J. '.l1\e undersigned hereby further cert.tfles OIxl declot-es: (a) I (Wp.) understand that the 1X1rchaser of the above uescribed properly illLends . lo r131y Oil the roregoinu r.epreselltat1ons In c0l1l1ectlo11 wilh Lhe l1n.l.ted Stoles ForelUII Il1veslmcltt ill Heal Properly '1'ax l\cl. (94 Slalute 2(,02 as lllllelldetl). (IJ) :I. Cwo) ulld13t:slnlld Lids cerU.ncaUolI IIny l;e tUsG.losed to L110 JlIlernal Hevellu8 Service by It:allsferee olld that OilY false statement contained ill this cerlJ.f.i.callon llIi.lY 1J0 lJ111.1sltec1 hy [.1.110, JmprJBolllllOllt ot" lXJtlt. Ulldet" ponalties or perjury I (we) declare I (we) have exomined carefUlly this certi- fication ond it is LnJe, correct and complete. 1991 at PI County, ;' f, Itj,. , ~. \L+J. ~ JOANNE DIXON MURRAY. .. 7 FLORIDA WHile ,",', ('lhis dOClU1lellt must be retained until the end of the fifth taxable year following the .,1 taxable yeor JI1 whlch the transfer takes ploce). CONSUlJl' YOun J\'lTOIlNI!:Y l\NIJ/OIt 'l'J\X l\IJVlson - NO HEPHESu'Wl'J\'l'lON on llECQIIlI'IENlJ1\'l'lON IS NI\lJB UY STu'W1\lfl' '1TJ'LI~ INSIJH1\NCI~ C{l\IPl\NY 1\NIJ/OH CONCEHNJNG TilE LEGi\I.. SUH;'JCJI::NCY J\NIJ/on 'l'i\X CONSQUI!.'NCES QLit 'I1US 1XX.'Uf'11!N1'. YOU Ni\Y BE lH~QUlIll!U TO nu~ i\ COpy Ol" TillS IXX:lJf'W:N'1' W.I'111 'l1"~ IN'i'EltNi\r, ImV~:NlJl~ SI~nVICE:. 'nll!:Sl~ l\1U~ QUI~S'1'10NS Icon YOun 1\'l'1'OnNJ~Y Olt 'l'i\X l\lJV ISUH. Ii," . ST1\TE OJ~ COUNTY m' FLORIDA PINELLAS I IIEIU!:OY Clm'l'H'Y that 011 LIIls day, before lIIe, all officer duly authorized ill the State aforesaid and in tlte County af;oresaid to lake aclmowledgtllents, personally (lppeared JOANNE DIXON MURRAY _ to me Imown to be the pel:slJtlS described in and who executed Lhe foregoing I11stnullent and they acknowlroyed Lefore hie that they executed the SOllie. WI'l'NESS my hand and official seal in the County nnd Slate last aforesaid lids 17111. day of DECEMBER , 19 91 . '.,'~ ,~, 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.Sj Regulations, including the possible withholding of twenty percent (20%).,of the current sales price. File Number: · 910601110 Taxpayer ID Number: Seller 1:<&;:l--~-5~~~ Seller 2 Taxpayer ID Type: 2 .( 1'= business, 2=individual) SELLER 1 NAME: Last: MURRAY First & Middle: JOANNE DIXON SELLER 2 NAME: Last: First & Middle: MAILING ADDRESS (as of January 31 of next year) SELLER 1: Street: State: PI Zip Code 3~7 /1 City: SELLER 2: Street: City: State: Zip Code: TRANSACTION INFORMATION Closing Date (MMDDYY): 12/17/91 Contract Sales Price: Seller 1 - 10,000.00 Seller 2 - (If multiple sellers please allocate the sales price among the sellers) Description of Property: Street Address: 1127 & 1139, BROWNELL STREET, CLEARWATER, FL 34616 Legal Description: Lars 8,9 and 11, LESS S 50' FOR STREET, BLK 2, MOASE & HARRISON SUB: under penalties of perjury, I, JOANNE DIXON MURRAY (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 Inte a Revenue Service. Date: Seller - 2 Signature: Date: 1c:J-- /7- q/ Seller - 1 Signature: CLOSING AGENT INFORMATION (to be completed by closing agent) Name: STEWART TITLE cn-1PANY OF CLEARWATER, INC. Mailing Address: 1290 COURT STREET City: CLEARWATER State: FL Zip Code: 34616 Taxpayer ID Number: 59-1433918 ,~ " M~'S \ 109Ji ' d I-- OMB No. 2502"0265 --->.--.--- U.S. DEPARTMENT OF HOUSING AND URB" N DEVELOPMENT -------- - A B. TYPE OF LOAN ---"-------~ - -- 1.0 FHA 2. 0 FMHA 3. 0 CONV. UNINS. 4. OVA 5 0 CONV. INS. 6. FILE 17. LOAN SETTLEMENT STATEMENT NUMBER 91060110 NUMBER 8 MORTG INS. CASE NO C. NOTE: This form is furnished to sive 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. I D. NAME OF BORROWER: CITY OF CLEARWATER, FlDRIDA PO BOX 4748 ADDRESS: I FTr. 14f117 E. NAME OF SELLER: DIXON, et. al ADDRESS: SELLER TIN: F. NAME OF LENDER: ADDRESS: CASH TRANSACTION G. PROPERTY LOCATION: LCYI'S 8,9 & 11, LESS S 50' FOR STREET, BLK 2, MJASE & HARRISON'S SUB OF LCYI' 7 OF R.H. PADG~ I S SUB a/k/a 1127 & 1139 BROWNELL STREET, CLEARWATER, FL 34616 H. SETTlEMENT AGENT: STEWART TITLE COMPANY OF CLEARWATER, INC. SETTlEMENT AGENT TIN: 59-1433918 ADDRESS: 1290 COURT STRE~ I CLEARWATER, FL 34616 PLACE OF SETTlEMENT: STEWART TITLE COMPANY OF CLEARWATER, :]:ETTl!ME.T DATE, -- ADDRESS: 1290 COURT S'I'RE~ DECEMBER 17, 1991 CLEARWATER FL 34616 351st DAY OF YEAR/14 REMAIN 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. Conlracl sales price 130,000.00 401. Conlracl sales price 130,000.00 102. Personal properly ~02 Personal properly 103. Seltlemenl charges 10 borrow (/ine 1400) 43.00 403 104. 404 105'JIWAR[6 SEIlER) Uffi]N; CIl3IS 2,750.75' 405. CREDIT FRJVI H.J'iER CN Uffi]N; CIEIS 2 750.75 Adjustments for items paid by seller in advance: Adjustments for items paid for seller in advance: 106. CityflovlI' laxes 10 406. Cily flown laKes 10 107. Counly taxes 10 407. Counly laus to 108. Assessmenls 10 408. Assessmenls 10 109 10 409 to 110. 10 410 10 111. 411 112 412 120 GROSS AMOUNT DUE FROM BORROWER: 132,793.75 420 GROSS AMOUNT DUE TO SELLER:: 132,750.75 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SEllER: 201. Oeposil or earnest money -0- 501. Excess deposil (see Inslructionsl 202. Principal amounl 01 new loan(s) 502. Sel11ement charges 10 seller lI,"e 1400) 12 600.50 203. Exisling loan Is) laken subjecllo 503 Existing loanls) laken sublec! 10 204. 504. Payol! ollirsl mortgage loan 205. 505 Payol! 01 second morlgage loan 206. ~. 1990 REAL ESTATE TAXES * 1 303.00 207. 507. PAYOFF JUDGEMENT/BERNARD DIXON 1 345.08 206 508. PAYOFF JUDGEMENT/JOSEPH DIXON 14 132.90 209. 509. Adjustments for items unpaid by seller: Adjustments for items unpaid by seller: 210. Cily flown taxes 10 510. City/town taxes 10 211. County laxes 10 511. Counly laxes 1/1/91 10 12/17/91 * 1 321. 32 212. Assessmenls 10 512. Assessmenls to 213 to 513. 10 214. 514. WELFARE LIEN/CHARLES DIXON R"OO 215. 515. MR. GEORGE CROPPS/CLEANING * lS.00 216. 516. ATTORNEY FEES/GRAY GIBBS * 425.30 217 517. JEAN CRANNEY/REIMBURSE TAXES * 2 000.00 218. 518 MRS. ErMAN WRIGHT/CLEANING * lS.00 219 519. REIMBURSE JOANNE DIXON/UPFRONT 150.00 220. TOTAL PAID BY/FOR BORROWER: -O- SlO. TOTAL REDUCTION IN AMOUNT DUE.lSElLER:~c..::l 33,356.10 300 CASH AT SETTLEMENT FROM/TO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross amount due from borrower (line 12{]) 132,793.75 601 Gross amount due to seller (line 420) 132,750.75 302 Less amounts paid by /for borrower (line 220) -0- 602. Less total reductions in amount due seller (line 520) 33,35g.1Q 303. CASH IIXFROMI~BORROWER: 132,793.75 603. CASH IOnOllomtlMKSELLER: 99,394.65 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. If you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required t(1 be reported and the IRS determines that it has not been reported. ' SELLER INSTRUCTION.lf this real estate was your prinCipal residence, liIe form 2119, Sale or Exchange 01 Principal Residence, for any gain, with your income tax return: for other transactions, complete the applicable parts of form 4797, Form 6252 and/or Schedule 0 (Form 1040). You are required by law to provide I. R. S with your correct taxpayer identification number. If you do not provide I. R. S with your correct taxpayer identification numbel, you may be subject to civil or criminal penalties. Under penalties of perjury, I certify that the number shown on this statement is my correct taxpayer identification number. Seller ! , I . '. . I rAGE 2 or OMO No. 2S0202f,S PAID FROM PAlO FROM L. SETTLEMENT CHARGES BORROWER'S SELlER'S FUNDS FUNDS 700. TOTAL SALES/BROKER'S COMMISSION Based on prlel S 130,000.00 @ 't,= 10,000.00 AT SETTLEMENT A T SETTlEMENT Division or commission (line TOO) as lollows: -----.- 701 S * 7,249.26 10 SLAN-EDWARDS REALTY , INC. 702. ~ 10 700. Commission paid al selllemenl * LESS S2750.74 '!WARDS SELLER CLOSING COSTS * In nnn QQ 70t 800 ITEMS PAYABLE IN CONNECTION WITH LOAN. 801. loan Originalion ree % 802. loan Discount 'f, 800 App,aisal Fee 10 804. C,edil Re~orl 10 80S lender's Inspeclion lee 806. Morlgage Insurance applicalion lee 10 807. Assumption Fee 808. 809. 810. 811. 900 ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE, 901.lnle,eSI lrom 10 @s Iday 902. Morlgage inSUla nee premium 10' mo. 10 903 Ilazard insurance p'emlum 'or yrs.lo 904. YIS. 10 90S. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard Insurance mo.@S per mo. ':' ~~</'; ~ i?,: f~'~'~t~.rf,y,g'!} \~:' ,;~:'~ "! 1002 Morlgage Insurance mo. @S per mo. ~>~I~r.!*: t~~~,:~v}!l~"r. :'~"':~J:j... 1003. Clly properly laxes mo.@S per mo. . 'i?,}:~~i(~~~'I,:~,f?;o;~7~, t~,~:~~~.:,;.'.:~, 1004. Counly properly laxes mo.@S per mo. .:..:'.",.....;,..;... _':.. . ~. ,f:" 1005. Annual assessmenls (Malnl.1 mo.@S per mo. ~ ri i ~:~:~/.~~~~~':!t.~;~~'\ l_~>.:~.~ -, .'-' ~ 1006. mo.@S per mo ?::~D~{tl~;!'!~~~:, (:. j'()f:.: 'k :.' .::{ ~', 1007. mo.@S permo. ;~~~t:~~~'!1~~.;~~.,~fJl: ~: ~~:t?~~~, I~ ;,~ ': ~ 1008. mo.@S per mo. :~,!~~. !~!~lf~~~%~~,~ ~.f;J~>~-~, 'it~:_ :";~:',;:\:. rf.~~' '~~, ~':,f ~~,~: { ..~? '~"~~-(~~ ,i':: :f~, ~~~-~-~~ -:',,' 1101) TITlE CHARGES: 1101. 5elllemenl or closing fee 10 1102. Abslracl or tille search 10 STC * 300.00 1100. Tille examinalion 10 1104 'ille insurance binder 10 1105. Documenl p,eparallon 10 1106. NOlary fees 10 1107. Allomey's lees 10 10 (inclUdes above items No.: ''''f*.r~'f.!~~ffi~~W~~: ~~. < ~1:'Y.I:rr...tilj t.;: . 1108. Tille Insurance (1101) 10 STEWART TITLE COMPANY OF CLEARWATER INC. * 1. 210 .00 (includes above items No.: ;:; ('(-:-;'::';::I;\~'?;t'.;f~(~"r.I! "'" . _:~\'"'".." ~~).\ .... ':t*..J, .,~ ~"'....,t,~....' ... '~. .', " ", ,,,....~ ,~' 'r, . ., Il09.lender's coverage S tt;':~We;.... ii~tJ:m1>Jt'1'i m\i ." '.. ;~'iN~~,~I!t~ ' ~":.: ",;,~",':1:~ Ilia. Owner's coverage S 130 000.00 ,..tl~!.~~~~t.t?t~\; .. ~"r. ..'. ,M~1~~':1 1111. II 12. 1113. 1200 GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. necordlng lees: Deed S 43.00 Morlgage S Releues S 6.00 JUDGEMENT /MYRI( t:K 43.00 6.00 1202. Cily/county lax/slamps: Deed S MO,lgage S 1203. 51ale tax/slamps: Deed S 780.00 Morlgage S * 7RO.nO 1204. RECORD AFFIDAVITS! cttl\RLES. DELORES. JOSEPH. JEANETTE 1205. 4 @ 6.00 1:'A,." ?4 00 1206. RECORD SATISFACTION OF JUDGEl1ENT I.TOSRPH . nTXON 10 "in 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey 10 EVANS lAND SURVEYING POC 1302. Pesl inspection 10 Nar , ED OR RFnUIRED 1303. MAILAWAY PREPARATION/COURIER 265.0(1 130t CITY OF CLEARWATER-LIEN SEARCH * 5.00 1305 -...... 1400 TOTAL SETTLEMENT CHARGES (entered on lines 'fJJ.-S-ectlon J ani/502, SectIon KJj A'l ()() l? hnn r;n ATlFICA lIOIl: I hive clre'ully rtvlt~:~~ E~~}\lllml(ii4;;~lftdbeHlf.R'lltrvI~;-:llm~IO~ ~IIP~ Ind dlld ~nll midi on my lecount 0' by mlln Ihll Irl"ucllon. lIe, Ih.. cer1l1y It' hlvl recllved I e~ ~ AA ,.A oy: L:1TY Vi" I . v I I. 11\1 MTTDD"AA I OHOW'" mkZ: !:elllll CHARLES DI~c~ To Ihe besl 01 my knOW'dli?,'h?,UD-lsellle~en!~la~mll1 ~ch I ha-,!~~r.ed)s a lrue and aCCU'lle"ICC~ olllle lundl which were received and have been or will be dlsbulSed by Ihe undersigned a)far17''ihe selll.me~0hls Ira"SAC I / -/7 '// /,.-'L,'7,'I{' or' 'i./A/ /}.~/? ~7' 'J , , 1. / , ,-::1::11. 7 JJ ~ A /-:';-rd T \ /G/ r7Y Orlem,"1 A8en~ ,Cll' . , . 0111 <--' u<. -;;:;r, I l EA' AN /0 PUR ASER'S IUTEMENT SIIIIr'1 Ind PUlchlser'. "gnalurl hlrlon leknowledgeehllllhelr Ipprovllollu prorlllonSlnd slgnllln Ihllr undl'slandl"g Ihal pro,allonl WI.I based on lUes 10' Ihl p.ecedl"~ . or ulima I.. Ihl eurrlnl yur, Ind In thllVlnl 0' Iny ching. lor Ih. eurrlnl Yllr, 111 necllUry adlullmenl. IllU!t be midi betwlln Selllr Ind Purchlur; lIk1wllf Iny dl'lull '" dellnqu.ntl.... will b. relmburs.d 10 Tille Compeny br, t . Seller. TII'. Complny. In III elPlcIIT, II hcrow Aglnt. II Ind hIS beln luthorlud 10 dlpolllllI lundl It rlCllvlS In Ihl.lrlnllellon In Iny IInlncllllnslllullon, whllhl' alllllated or nol Such IInanclal Inslllullon mAY provide '" e Company compul" counlln, and audll servle.. d ,eelly or Ih'OU~h I lepl.ale Intlty which, "I"'"aled with TlIlICompany, mllchl,glthl 'Inlncllllnllllullon'luonlble and proeer com~ensalion Iher,'ore a"d rllaln any prolilS therefrom. Any OWow lo.s ~Ald by any IIV Invo vod In Ihls I.a",aclion shalloo'y hi o. chockw,llIng Ind Inpullothe compullr., bul nollo, I'olln d lecountl Ind ludllllrvlces. Tltlo Complny shal nol bo lablolo. any Inloreslo' othor charg., n" tho .arnosl man. a"d !hall 0 uod" no I 10Inveslorrelnvo,lIund.holdb IIllan Iimo.SolllSlndrurcha!IIShereb Icknowlod undc n,onll Ih de , cr w n I IIn I I TlI man ha!nrmo AVO . . , V Y Y ""011110 Ih. retonllon by TlIII Company and lor 115 af C'ow ;If,r.o''nl~ 111, l'Allie. hove road the ahovo, to cu. eta UCha!",,~o,,:w.rCl'rY' ! --~. -- ~R.I".: II Is I c,lmo 10 knowingly mlkllll.. slalements I. Ih .y goo I PO~IO Ihees 0 mo oy n Incial nslllutlnnswllhwhch leCo p Y yh olh"banklng'OrA"O"Shlp"n"'urtl1" les 01 any and all beneh!! (Including advantag,ouI Inllr..llallSOn loan.) 1It1. Compan a . elve from such finanelallnshtullon. by reason 01 their mAinlo"AnCO of said f o sarno. and IICOg"'lI ompa, ~~~hl same (/ S.II,!!- .~,,- nr:rm,I\RD AON ___ ed SlallS on Ihis or any olher similar lorm. Plnall~n conviction can Includ. a 'Illllnd imp.lsonmlnt. for dllalls... TIIII 18 US r.nd. ~.rhnn 'M. 'ft" .""ft_ 'n,n .' '..- I I MIS LDr 700. TOTAL SALES/BROKER'S COMMISSION BI18d on price S 130,000.00 @ Division 01 commissIon (Ime 100) as lollows: ....= 10 000.00 PAlO FROM BORROWER'S FUNDS AT SETTLEMENT PAGE 2 OF OMS No. 2502026' PAID FROM SELLER'S FUNDS AT SETTLEMENT "" L. SETTLEMENT CHARGES 701$ 702. $ * 7,249.26 to BIAN-EDWARDS REALTY, INC. to 703 Commission paid al selllement * LESS $2750.74 TOWARDS SELLER CLOSING COSTS * 1 n nnn m 704. 800 ITEMS PAYABLE IN CONNECTION WITH LOAN. 801. Loan Origination lee 802. Loan Discount 803. Appr aisal Fee 804. Credit Report 805. Lender's inspection fee 806. Mortgage Insurance application fee 807. Assumption Fee % % to 10 10 808. 809. 810. 811. 900 ITEMS REQUIRED BY LENDER TO BE PAlO IN ADVANCE. 901.lnteresl Irom to @s /day 902. Morlgage insurance premium tor mo. to 903 Hazard insurance premium 'or yrs. 10 904. yrs. 10 905. 1000 RESERVES DEPOSITED WITH LENDER 1001. Hazard insurance 1002 Mortgage insurance 1003. City property laxes 1004. County properly taxes 1005. Annual assessments (Maint) 1006. 1007. 1008. mo.@S per mo. mo.@S per mo. mo.@S per mo. mo.@S per mo. mo"@S per mo. mo.@S per mo. mo@S per.mo. mo.@S per mo. ,,:'.:'., '.t?::;'<;;!f'i;~:~"'rf~~~.~'~'~~." . :;~t:I~!:~~;~1f:~':"~?~\;':~, '., <:,;:,,,',,,;';' t,:~,!.; ~W,<.:'. 1100. TITLE CHARGES: /:~tt}~.:~~,.~i;~~(~1'~~~:~'~*1i,!~ : :..'M~~:-t!?~ 'I~~:t~~~::~~~:,~' 1~"r~'!1~.~~~~*'f~~l 1101. Settlemenl or closing fee 1102. Abstract or lille search 1103. Title examination 1104. Tille insurance binder 1105. Documenl preparation 1106. Notary 'ees 1107. AIlorney's lees to (includes above ilems No.: 10 10 to 10 10 10 to SIC * 300.00 1108. Tille Insurance ( 1101 ) t!~; . s S 130,000.00 ,;, .." vt:. o;:~. * 1 210.00 ;;~i~,i:;'~f+~':!:i(;!;;"r..;i;1%fiji .;._.: '., ".~. . . "#9\: w.-:,s.k.,tw!. ' "ii," ~li-~'}1~,~ " t ( . ',~ ~~i& ~..., . "'{'~f":'::1{~.1;I."l.~,_I~'" d'..~.~'~!~~ ~~'~!~~ ,...?'. ,c' '11'" '.. ~ ',. , ,- > /'. ,'. ~ (inCludes above ilems No. . 1109. Lender's coverage 1110. Owner's coverage 1111. 1112. 1113. toSTEWART TITIE COMPANY OF CLEARWATER. INC. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees: Deed S 43 . 00 1202. City/county lax/stamps: Deed S 1203. Stale tax/stamps: Deed S 780.00 RECORD AFFIDAVITS/CHARLES DELORES. JOSEPH. JEANETrE 4 (CI 6.00 Yi'AI"U 1206. RECORD SATISFACTION OF JUDGEMENT/JOSEPH 1300. ADDITIONAL SETTlEMENT CHARGES Mortgage S Mortgage S MOrlgage S Releases S 6.00 JUDGEMENT /MYRI X III XI IN 43.00 6 00 * 7RO.00 24.00 In SO POC ')c;c nn 1< C). 00 1204. 1205. 1301. Survey 1302. Pest inspection 1303. 1304. to EVANS lAND SURVEYING 10 Nor ~I' II w'-'TED OR RFnUIRED MAILAWAY PREPARATION/COURIER CI'IY OF CLEARWATER-LIEN SEARCH 1305. 1400 TOTAL SETTLEMENT CHARGES (entered on lines 103, SectIon J and :xJ2, Sect/on K) / Lt, nn 1') hnn c:;n CERTlFICA TlOIl: 1 have c.alt'UIlY reVI!~thy(y/J~, SelllelRan Slalemenla'l1tO!he beslol my knowledoe and ballef, It Is l'rUI Ind ~Ilement 0' all recllptsed di~~r~emenls made on my ~nt% by me In this transacllon.llv;ther certify thatlhav"eceIVedaco~1JZ;em~leme E- IU. jll -r1-- / //IIA/,{ /i A"TJ//~..A1 / J-f f,4/ ~ /_ oy: L.ITY U1" LJ...fJ\ ;Xr. K { ( 'I<:Ar 'l(111\Y l/.!AA ...; ,~ ~. '- ~~;~ewb~s~ 01 my ,,"owledge,t~U6'1 settl:ment Slate~ I have~redli a Irue and accurate account 01 the lunds whlcl1 we~:~::ived an/J.e been or will be disbursed by Ihe undersif:ed as pa~~~I~~~f Ih~ ~~n. /'1 . , . ; "7 lt2' 1 , ,..' , ~ "~ /~.'/' ",1{..J' .. ),K,. '.I V7ae-/... ~ UEC.l2V1Jjt'J{ 1), 1~~1 SetllemJnl A.lIenl L.. -- - Olte SElLER'S AND/OR PURCHASER'S STATEMENT Seller's and Purcheser'l Ilgnatult herlon acknowlldges hlllthllr approval oltn prorallons and Ilgnllles Iheir undlrstandlng thaI prorallons were basld on ta~es for Ihe preceding year, or eslimat.s lor the currin I year, and In thl eVlnl of any change lor Ihl currlnl year, III necessary IdJustmenls must ba made between Sell.r Ind Purcheser; likewise any default In dellnquentl..es will be reimbursed to Till. Company br, Ihe Seller. Till. Company, In Its capacity as Escrow Agenl, Is and hes been aulhorlzed to deposll all 'unds II recllv8I1n this Iranlacllon In any IInanclallnstllullon, whelher alflllated or not. Such lInanclallnstltutlon may provldl Til e Compeny computer accounting and ludlt services directly or through a leparale enlily whlch,lIa1llllatld with Title Complny, maycharglthe IInanclallnstltullon reasonable and pro r compensation therefor I and retain any prolits therefrom. Any escrow lees paid by any partv Involved In this Iransaclion shalf only be for check writing and Inpulto the computerl, but not lor aloresald accounllng and audit lervlces. TIlle Company sh 01 belfabl. for any Inl.resl or other charg.s on the earnesl money and shall be und.r no duty to invest or relnvesl funds held by It at any lime. lIer. and Purchasers hereby acknowledge.nd consenllo Ihe deposit 0' the eScrow money In flnlnclall II Ions wllh which TltI. Com ny has or may hlv. oth.r nklng relalionships ond Iurlh., co"..nllo the r.tention by TI.tle Company and/or It a i1late~ol a and all benefits (Including advantageouslnlllest rates on loans) Tille Complny and/or . al latls mlY r.ceive from s flnan~iallnsll'ullons b ason olth.lr m~int nance 0' soid flSCIOW accounts lh. pRrties hove read the abov a ree to sam., and recognize litll Company IS relying ~ __ Purchasers~o,,~w.r SllIers WARNINB, Ills a crime 10 knowingly make 'alse .'alements t ~ ' I , I S,,,,,"t;l.t of (',"'tro,"t RONALD (RONI E. SOMERS President 1290 Court Street Clearwater, Florida 34616 s'rE"\-VAI{'r'rI'I'I.JE OF CLEARWATER P.O. Box 2756 Clearwaler. Florida 34617 (813) 441,2689 Atrl'IIORIZATION AND ACKNOWLEDGEMENT FORM Reference: FILE NO. 91060110 LEGAL LarS 8, 9 and 11, LESS S 50 ' FOR STREET, BLK 2, MOASE & HARRISON SUB S~ER BUYER CITY OF CLEARWATER, FLORIDA We hereby approve and acknowledge receipt of a copy of the Statement. and actual cost (DISCLOSURE/SEITLE1v1ENT STATEMENT - BUD FORM 1) and authorized disbursement of funds as shown therein this 17 day of DECEMBER / 19~1 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 lIude in this proration when the tax bill is received, it will be handled between the parties of this transaction. Stewart Title Company of Clearwater, Inc., will not be held responsible. It is further understood that Stewart Title COlnpany of Clearwater, Inc., cannot, at this time, assertain if there will be personal property tax on subject property or an amount on which to base a proration. Any proration necessary when tax bills become available will be handled between the parties to this transaction, outside of Stewart Title Company Company of Clearwater, Inc. Stewart Title Company of Clearwater, Inc., will be not held responsible. 'lHAT AIL tJITLI'lY BILLS (WATm, SE1im, ELEI:lRIC, MAlNl.>>mNCE FEES) HAVE BEEN PAID OR WILL BE PAID UPON REX::EIPr OF FINAL BILLS. vu./l/ INITIALS a INITIALS 17>: -c~ ~~41f1u~ *- SEILER'S FORWARDING ADDRESS: BUYER'S FORWARDING ADDRESS: Po. &y: -I7f? ~~.~ 316td HG1EPHONE# HOME PHONE# hURl< PHONE# WORK PHONE# t/G 7- -C;7 (,0 '!HIS IS TO FURTHER AUTHORIZE CHANGES NECESSARY TO '!HE CLOSING STATE1'1ENr. '1'0 APPROVE: ANY S'l'EWARf TITLE c:a1PANY "OF CLEARWATER, INC. BY: ] 1 RONALD IRON) E. SOMERS President 1290 Court Street Clearwater, Florida 34616 S"","li/._ "I f.'()t."nrL S'rE'VAl{'r 'rI'l~J...E OF CLEARWATER P.O. Bo)( 2756 Clearwater, Florida 34617 (813) 441,26B9 AUTHORIZATION AND ACKNOWLErx:;EMENT FORM Reference: FILE NO. 91060110 LEGAL LarS 8, 9 and 11, LESS S 50 I FOR STREET, BLK 2, IDASE & HARRISON SUB CHARLES DIXON SEILER BUYER CI'IY OF CLEARWATER, FLORIDA We hereby approve and acknowledge receipt of a copy of the Statement and actual cost (DISCLOSURE/SETI'LEMENT STATEMENT - fRill FORM 1) and authorized disbursement of funds as shown therein this 17 day of DECEMBER , 19~1 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 infonna.tion available. If any changes are to be made in this proration when the tax bill is received, it will be handled between the parties of this transaction. Stewart Title Company of Clearwater, Inc., will not be held responsible. It is further understood that Stewart Title Compa.ny of Clearwater, Inc., cannot, at this time, assertain if there will be personal property tax on subject property or an amount on which to base a proration. Any proration necessary when tax bills become available will be hillldled between the parties to this transaction, outside of Stewart Title Company Company of Clearwater, Inc. Stewart Title Company of Clearwater, Inc., will be not held responsible. 'llIAT ALL l1ITLITY BilLS (WATER, ~, ELEX:lRIC, M1\lN'I'EXl\NCE FEES) HAVE BEEN PAID OR WIlL BE PAID UPON RFX::EIPl' OF FINAL BilLS. ChV/lL CHARLES DIXON /j ;/trl I ~. C/D. INITIALS SElLER I S FORWARDING ADDRESS: BUYER'S FORWARDING ADDRESS: HCX'1E PHONE# HQ\1E PHONE# hDRK PHONE# WORK PHONE# 'TIUS IS TO F1JR'l'HER AU'llIORIZE CHANGES NECESSARY TO 'IHE CLOSING STATEMENT. TO APPROVE; ANY S INC. BY: " 2c..'/.... TolBE FILLED IN PERSONALL vi BV SELLER OR BORROWER IN HIS OWN HANDWRITING INDEMNITY AND AFFIDAVIT AS TO DEBTS, LIENS, AND POSSESSION USE SEPARATE FORM FOR EACH PARTY CHARLES DIXON Seller or Owner-Borrower LOTS 8,9 and 11, LESS S 50 t FOR STREET, BLK 2, MOASE & HARRISON SUB 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 fO.llowing: (If none, so state.) I NAME AND AD~ SS 0 E RED PARTY C I ( Approximate Amount following: (If none, so state.) Approximate Amount 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 DRESS OF UPPLlER OF LABO SE CES OR MA TERIALS Approximate Amount · yo 4. I, the purchaser, represent that I have no knowledge of any debts or liens of any kind other than those listed above, except: (If none, so state,) NAME AND ADDRESS OF SECURED PARTY, CREDITOR, SUPPLIER OF LABOR OR MATERIALS Approximate Amount 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 HAVE AN INCEPTION DATE PRIOR TO THE CONSUMMATION OF THIS TRANSACTION. I realize that the purchaser and/or lender in this transaction are relying on the representation contained herein in purchasing sa or len~in~ money th reon and would ~t pUfchase same or lend money thereon unless said representations were made. '- C ~l ..J l}V-- CHARLES DIXON S\\?;;~TO JND Sl!BSCRI~:;~ORE ME THIS 7/( . f/II,I~ J(fl(./,;z,'2 /J/// I" /~ My Commission Expires: '1'-:) Lj':7'c7 Notarr ublic in and~ ' PINEILAS CountY'F1DRIDA NOTE: Thi. form is to be signed by teller in case of ..Ie. II no ..Ie. it it 10 be lilftCd It)' the OIllMr.bonOMr. If there it any new conl.ruetion. the contractor mull al.o join in Ihit form or .ian a separate onc. lTl J day of I DECEMBER 91 ,19_. Rev. 1/88 1 1 S"''''/;I.y "I ("III/,,,rt RONALD (RON) E. SOMERS President 1290 Court Street Clearwater, Florida 34616 S~'EWAlI'I. ~'rrLE OF CLEARWATER P.O. Box 2756 Clearwater, Florida 34617 (8131 441.2689 D I S C LOS U R E We, the Owners of that certain real property located at LarS 8,9 and 11, LESS S 50 I FUR STREET, BLK 2, MOASE & HARRISON SUB broker, the selling broker, and any prospective buyer. t 1tness ~itlODjiu~ Witn ss (! lAA LV ~11'^- GlARLES DIXON STATE OF FLORIDA COUNTY OF PINELIAS SWORN TO AND SUBSCRIBED BEFORE ME THIS /7Ul DAY OF DECEMBER ,19 91 My Commission Expires: tJ.;;. (-9d- /)?d.?~ 'I I NON-fOIHUGN CEH'l'.LF'lC^'1',LOH /Jy HIIJIV lUUM, 'l'Il1\NSrEHOH 1. Sectioll 11\45 of; Lhe IllLerllal Hevel1ue Cwe pruvJ.uen lhnt n tni\,sfel:ee 1,'( 0 United Slates I:eal pt'operly illle.;est IIIUst wIlhhold lox if the tt'ollsferor is /J foreiyn lJersol1. 2. III onJE!I: to .lllrOUn the tnlllsferee Lhot wlLhho.LdlllV of tax 113 !lot required upon Lhe ll.lSpos.l.Uoll hy CHARLES DIXON of tile Ul1lled Stutes reo1 property uescrlbed os follows: LarS 8,9 and 11, LESS S 50 I FOR STREEI', BLK 2, MJASE & HARRISON SUB the unuel-signeU transferor certifies ond declares by means of Lhis certification, lhe following: (a) I (We) OJn (ore) not Iloll-resident a11ell(s) [or (XJrposes of Ulliled Stoles illcollle laxa U,on on(l, (b) t1y Un!l c'<l States N1\NE - CHARLES DIXON taYPt,pe.r identifylllg Illllnoor(B) (Social Security NUllIbn-) is/are: SOCl/\f.. S~X:UIU'I"l NLJIIlIJEIt /-, t ? - (;77- 5'-;) ~ 7 :J. " H " " (c) t1y hOIllE! {I<klnms Js (ulloc!lCll addJUollal paye .i.f lIecessm:y) (d) Thete ore lIO oLhm: persolla who have 011 oWlleJ:fjhJp Jlllercst ill lhl! uIJUvo-deucd.bed properly olhor lImll lhose lJeJ:SOIIB set forlh obove 111 subpa.:ogrol~l (b). J. '.11113 \lJlderslgllcd hereby [ut-ther cert.lfles and declares: (0) I (We) underslolld that the (XJrchaser of the obove described properly Illtends . to rely 011 the fotegoinU r.epreselllaU.oIlS 111 COllllecU_olI wJ.th lhe lhd,ted SLnLes 1''oreJy'' Illvesltllellt ill Heal Property 'l'ux l\ct. (94 Sh,tllte 2(;U2 us {lIl1ended). (11) .I. Cwo) ullder:allllld Lids certJ.f.tcoUolI IIny 1)(J tUsc.1.oaed to Lhn llllemal Hevelllle Ser.v.i.ce by transferee allu that OilY false stalelllent cOlltoined ill L1lls cerUf.i.caLlon lIli.IY IJ(! lllllll.sl\(!c1 hy [Jlln, .lJllpt.l.nolllllOl1t 01: lx)th. Under (x111ullles of perjury I (we) declare I (we) have eX811ulled carefully lIlls cerll- f!callon and it is h-ue, cor.rect and complete. lJa te ~Je W tl1 BS ,'I', ('lhi doclUllent h1ust be retained w1l:il the end of lhe fifth taxoble year following the': taxable year 111 wh.Lch Lhe transfer takes place). CONSUJJl' YOUn l\'l'l'OllNI!:V 1\NIJ/OIl 'l'1\X 1\l)VlSOn - NO HEPHESl!.N'lWl'lON Oil HECOI'l'lENUNl'lON IS N1\IJI!: BY STl!.WI\I t'l' 'J'l'J'LI~ INSIJH1\NCI~ c(l'IPI\N'f 1\NIJ/OH CONCgllNJNlJ '1'1 IE LEGl\l.. sun;'JCJE:NCY 1\NIJ/OH 'l'1\X CONSQUI!:NC1!:S OLl' '1111S LXX:UNI~tlr:-voU NI\'f BE IlI~QUIHEU 'lD F..tLI~ 1\ COpy or TilLS IXX:tJMliNl' W.I'lll '1'11I~ IN'l'EllNl\r~ IUW~:NlJl~ SI~IlV.LCl!:. '.11 m:s,~ 1\1l1~ OU'~Sr10NS FOil YOUIl A'l'1DHNI~Y Oil 'l'1\X AIJV iWIt. (} FLORIDA COUllty, , l e-1L 1)' ~! CTV\ CHARLES DIXON 1991 at PINELLAS I" ",' S'l'A'm Ol~ COUN'lY m' FLORIDA PINELLAS ~~..~ ::Jl NOl'fll PUUI..J.C MY C 1'1ISSION ~~xPllms l 7,-yy'-J:3 I' I INFORMATION FOR REAL ESTATE 1099-S REPORT FILING Section 6045 of t~e Internal Revenue Code, as amended by.the Tax Reform Act of 1966, requires the 'reporting of certain information on every real estate transaction. From the information yOu provide below, a Form 1099-S will be produced, a copy of it will be furnished to the I.R.S. and to you no later than January 31 of the next year, and a copy may be sent to other third parties. If you fail to furnish adequate information (in particular, a taxpayer ID number), then you will be subject to all I.R.S. Regulations, including the possible withholding of twenty percent (20%).of the current sales price. File Number: · 910601110 Taxpayer ID Number:Seller 1 , C;; ~t?f~ 72-- Seller 2 . Taxpayer ID Type: 2 ~1= business, 2 = individual) SELLER 1 NAME: Last: DIXON First & Middle: CHAIRES SELLER 2 NAME: Last: First & Middle: MAILING ADDRESS (as of January 31 of SELLER 1 Street: Zip code:) If?/ f City: State: SELLER 2: Street: City: State: Zip Code: TRANSACTION INFORMATION Closing Date (MMDDYY): 12/17/91 Contract Sales Price: Seller 1 - 10,000.00 Seller 2 - (If multiple sellers please allocate the sales price among the sellers) Description of Property: street Address: 1127 & 1139, BROONELL S'IREET, CLEARWATER, FL 34616 Legal Description: LarS 8,9 and 11, LESS S 50' FOR STREET, BLK 2. MOASE & HARRISON SUBI Under penal ties of perjury, I, GlARLES DIXON (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 best of my understanding and I understand that it will appear on a 1099-S that will be sent to me and to the Intern ~le~~~ue ~ervice Date: Seller - 1 Signature: It ~l ~ the Form Date: Seller - 2 Signature: CHAIRES DIXON u-v--- CLOSING AGENT INFORMATION (to be completed by closing agent) Name: STEWART TITLE <XX'1PANY OF CLEARWATER, INC. Mailing Address: 1290 COURT STREET City: CLEARWATER State: FL Zip Code: 34616 Taxpayer ID Number-: 59-1433918 I I ^ F F I 0 ^ V I T STATE OF FLORIDA COUNTY OF Pine1las BEFORE ME, THE UNDERSIGNED AUTHORITY, personally appeared CHARLES DIXON who being by me first duly sworn deposes and says: That he is not one and tlte same person as CHARLES L. DIXON, CHARLIE L. DIXON,CHARLES L. DIXON, CHARLES M. nIXON, CHARLES W. DIXON and CHARLES S. DIXON who i s n a m e din liens, judgrnen ts and Tax liens a s r e cor d e din O. R. Boo k . 4474 Page 266, ** Public Records of Pinel1as County, Florida. Affiant further states that his Social Security Number is as ** 4501, Page 205; O.R. Book 5101, Page 720; fol lows: O.R. Book 6101, Page 1144; O.R. Book 6174, Page 1619; O.R. Book 6681, Page 108; O.R. Book 7408, Page 1669 and O.R. Book 7617, Page 802 Signed, sealed and delivered in th presence of: C(~L CHARLES DIXON b~~ ~~u of A<1/;(}~[}w/~ Sworn to and subscribed before me this 17th day of December, , 1 9 91 My Commission expires: 9dt/-'1;;J This instrument prepared by: MIKELL L. ST. GERMAIN for: Stewart Title Co. of Clearwater 1290 Court Street P.O. Box 2756 Clearwater, Florida .346IG. 34617 AlTA-OWNEr;j'S POLICY - (4-6-90) WITH FLORIDA MODIFICATIONS - 1 POLICY OF TITLE INSURANCE ISSUED BY 91060110 STEWART TITLE GUARANTY COMPANY ~~ nr~ SUBJECT TO THE EXCLUSIONS FROM C SCHEDULE B AND THE CONDITIONS AND corporation, herein called the Company, insures exceeding the Amount of Insurance stated in Sc 1. Title to the estate or interest described in 2. Any defect in or lien or encumbrance on 3. Unmarketability of the title; 4. Lack of a right of access to and The Company wi II also pay the costs, to the extent provided in the Conditions IN WITNESS WHEREOF, Stewart T duly authorized officers as of the Date RAGE, THE E.PTIONS FROM COVERAGE CONTAINED IN PULATIONS, STUART TITLE GUARANTY COMPANY, a Texas of Date of Policil~hown in Schedule A, against loss or damage, not Ie A, sustained or.~~curred by the insured by reason of: Ie A being ve.d ~ther than as stated therein; defense of the title, as insured, but only this policy to be signed and sealed by its Company 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 (incl uilding 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 or ns 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 inances or governmental regulations, except to the extent that a notice of the enforcement thereof or a notice of 0 defect, lien orsencumbrance resulting from a violation or alleged violation affecting the land has been d d. h bl' d 0 f P I' '. ancw)" ,If C ollfmn recor e In t e pu IC recor s at ate 0 0 ICY. . , (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 affecting 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 CompanYI 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 c10imant prior to the date the insured claimant became an insured under this policy; (c) resulting in no loss or domage 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 ~ ~ ~ ~ - ~ ~ ~ - 16650 211 (Rev. 4-6-90) CONDITIONS AND STIPULATIONS 1. DEFINITION OF TERMS, (d) In all cases where this policy permits or requires the Company to prose- The following terms when used in this policy mean: cute or provide for the defense of any action or proceeding, the insured shall (a) "insured": the insured named in Schedule A, and, subject to any rights secure to the Company the right to so prosecute or provide defense in the action or defenses the Company would have had against the named insured, those who or proceeding, and all appeals therein, and permit the Company to use, at its succeed to the interest of the named insured by operation of law as distinguished option, the name of the insured for this purpose. Whenever requested by the from purchase including, but not .limited to, heirs, distributees, devisees, survivors, Company, the insured, at the Company's expense, shall give the Company all personal representatives, next of kin, or corporate or fiduciary successors. reasonable aid (i) in any action or proceeding, securing evidence, obtaining wit- (b) "insured claimant": an insured claiming loss or damage. nesses, prosecuting or defending the action or proceeding, or effecting settle- (c) "knowledge" or "known": actual knowledge, not constructive knowledge ment, and (ii) in any other lawful act which in the opinion of the Company may or notice which may be imputed to an insured by reason of the public records as be necessary or desirable to establish the title to the estate or interest as insured. defined in this policy or any other records which impart constructive notice of If the Company is prejudiced by the failure of the insured to furnish the required matters affecting the land. cooperation, the Company's obligations to the insured under the policy shall ter- (d) "land"; the land described or referred to in Schedule A, and imp,rove- minate, including any liability or obligation to defend, prosecute, or continue any ments affixed thereto which by law constitute real property. The term \ land" litigation, with regard to the matter or matters requiring such cooperation. does not include any property beyond the lines of the area described or referred 5. PROOF OF LOSS OR DAMAGE. to in Schedule A, nor any right, title, interest, estate or easement in abutting In addition to and after the notices required under Section 3 of these Condi- streets, roads, avenues, alleys, lanes, ways or waterways, but nothing herein shall tions and Stipulations have been provided the Company, a proof of loss or dam- modify or limit, the extent to which a right of access to and from the land is age signed and sworn to by the insured claimant sholl be furnished to the Com- insured by this policy,. pany within 90 days after the insured claimant shall ascertain the facts giving rise (e) \ mortgage ': mortgage, deed of trust, trust deed, or other security to the loss or damage. The proof of loss or damage shall describe the defect in, instrument. or lien or encumbrance on the title, or other matter insured against by this policy (f) "public records"; records established under state statutes at Date of Pol- which constitutes the basis of loss or damage and shall state, to the extent possi- icy for the purpose of imparting constructive notice of matters relating to real ble, the basis of calculating the amount of the loss or damage. If the Company is property to purchasers for value and without knowledge. With respect to Section prejudiced by the failure of the insured claimant to provide the required proof of l(a)(iv) of the Exclusions From Coverage, "public records" shall also include loss or damage, the Company's obligations to the insured under the policy sholl environmental protection liens filed in the records of the clerk of the United States terminate, including any liability or obligation to defend, prosecute, or continue --districtcourtforthedistriain-wnichthe land-is located. - - any litigotion,-with regard to the-matter_ol" matters requiring such proof oLloss or - -I (g) "un marketability of the title": an alleged or apparent matter affecting damage. the title to the land, not excluded or excepted from coverage, which would entitle In addition, the insured claimant may reasonably be required to submit to o purchaser of the estate or interest described in Schedule A to be released from examination under oath by any authorized representative of the Company and the obligation to purchase by virtue of 0 contractual condition requiring the shall produce for examination, inspection and copying, at such reasonable times delivery of marketoble title. and places as may be designated by any authorized representative of the Com- 2. CONTINUATION OF INSURANCE AFTER CONVEYANCE OF TITLE. pany, all records, books, ledgers, checks, correspondence and memoranda, The coverage of this policy shall continue in force os of Date of Policy in whether bearing a date before or after Date of Policy, which reasonably pertain favor of an insured only so long as the insured retains an estate or interest in the to the loss or damage. Further, if requested by any authorized representative of land, or holds on indebtedness secured by 0 purchase money mortgage given by the Company, the insured claimant shall grant its permission, in writing, for any o purchaser from the insured, or only so long os the insured sholl hove liability by authorized representative of the Company to examine, inspect and copy all reason of covenants of warranty made by the insured in any transfer or convey- records, books, ledgers, checks, correspondence and memoranda in the custody once of the estate or interest. This policy sholl not continue in force in favor of or control of a third party, which reasonably pertain to the loss or damage. All any purchaser from the insured of either (i) on estate or interest in the land, or (ii) information designated os confidential by the insured claimant provided to the on indebtedness secured by 0 purchase money mortgage given to the insured. Company pursuant to this Section shall not be disclosed to others unless, in the 3. NOTICE OF CLAIM TO BE GIVEN BY INSURED CLAIMANT. reasonable judgment of the Company, it is necessary in the administration of the The insured sholl notify the Company promptly in writing (i) in case of any claim. Failure of the insured claimant to submit for examination under oath, pro- litigation os set forth in Section 4(0) below, (ii) in case knowledge shall come to duce other reasonably requested information or grant permission to secure reo- on insured hereunder of any claim of title or interest which is adverse to the title sonably necessary information from third parties os required in this paragraph to the estate or interest, os insured, and which might couse loss or damage for sholl terminate any liability of the Company under this policy as to that claim. which the Company may be liable by virtue of this policy, or (iii) if title to the 6. OPTIONS TO PAY OR OTHERWISE SETTLE CLAIMS; TERMINATION OF estate or interest, os insured, is rejected os unmarketable. If prompt notice sholl LIABILITY. not be given to the Company, then os to the insured 011 liability of the Company In case of a claim under this policy, the Company sholl have the following sholl terminate with regard to the matter or matters for which prompt notice is additional options: required; provided, however, that failure to notify the Company shall in no case (0) To Payor Tender Payment of the Amount of Insurance, prejudice the rights of any insured under this policy unless the Company shall be To payor tender payment of the amount of insurance under this policy prejudiced by the. failure and then only to the ext~nt of the prejudice. together with any costs, attorneys' fees and expenses incurred by the insured 4. DEFENSE AND PROSECUTION OF ACTIONS; DUTY OF INSURED claimant, which were authorized by the Company, up to the time of payment or CLAIMANT TO COOPERATE, tender of payment and which the Company is obligated to pay. (0) Upon written request by the insured and subject to the options contained __ ~__ _ ~~~the exercise by the ~ompa~yo!~his ~l'ti<>.~,aJllia~ility and_ obligations inSectici-" 6 of these Conaitions(ina'-sfiputaliol'f~~y,al itfowni:OSf - 10 the Insured under ThiS pottcy, OfIfer tl1an romare the payment requiflld, snatt and without unreasonable delay, sholl provide for the defense of on insured in terminate, including any liability or obligation to defend, prosecute, or continue litigation in which any third party asserts 0 claim adverse to the title or interest os any litigation, and the policy sholl be surrendered to the Company for insured, but only os to those stated causes of action alleging a defect, lien or cancellation. encumbrance or other matter insured against by this policy. The Company sholl (b) To Payor Otherwise Settle With Parties Other than the Insured or hove the right to select counsel of its choice (subject to the right of the insured to With the Insured Claimant, object for reasonable couse/ to represent the insured os to those stated causes of (i) to payor otherwise settle with other parties for or in the nome of on action and shall not be liab e for and will not pay the fees of any other counsel. insured claimant ony claim insured against under this policy, together with any The Company will not pay any fees, costs or expenses incurred by the insured in costs, attorneys' fees and expenses incurred by the insured claimant which were the defense of those causes of action which allege matters not insured against by authorized by the Company up to the time of payment and which the Company this policy. is obligated to pay; or (b) The Company shall have the right, at its own cost, to institute and prose- (ii) to payor otherwise settle with the insured claimant the loss or dam- cute any action or proceeding or to do any other act which in its opinion may be age provided for under this policy, together with any costs, attorneys' fees and necessary or desirable to establish the title to the estate or interest, as insured, or expenses incurred by the insured claimant which were authorized by the Com- to prevent or reduce loss or damage to the insured. The Company may take any pony up to the time of payment and which the Company is obligated to pay, appropriate action under the terms of this policy, whether or not it sholl be liable Upon the exercise by the Company of either of the options provided for in hereunder, and shall not thereby concede liability or waive any provision of this paragraphs Ib){i) or (ii), the Company's obligations to the insured under this pol- policy. If the Company shall exercise its rights under this paragraph, it shall do so icy for the c aimed loss or damage, other than the payments required to be diligently. made, shall terminate, including any liability or obligation to defend, prosecute (c) Whenever the Company shall have brought an action or interposed a or continue any litiQation. defense as required or permitted by the provisions of this policy, the Company 7. DETERMINATION, EXTENT OF LIABILITY. may pursue any litigation to final determination by 0 court of competent jurisdic- This policy is a contract of indemnity against actual monetary loss or dam- tion and expressly reserves the right, in its sole discretion, to appeal from any age sustained or incurred by the insured claimant who has suffered loss or adverse judgment o,r order. 1_ damage by reason of.ratters insured against by this policy and only to the . extent herein describe, (continued and concluded 0':1 last page of this policy) ~.~ -- AL TA OWNER'S POLICY ./ I I mls 16650 SCHEDULE A Order No.: 91060110 Policy N8:':'2111- 16650 Date of Policy: December 18, 1991 Amount of Insurance: $ 130.r 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: Lots 8, 9 and 11 less south 50 ft, for street, Block 2, MOASE AND HARRISON'S SUB, PB H-2, Pg. 85, Pinellas County, Florida. ALS(:) DESCRIBED AS: Lots 8, 9, and 11 less South 50 ft. for street, Block 2, MOASE AND HARRISON'S SUBDIVISION of Lot 7 of R.H. PADGETT'S SUBDIVISION, according to the Plat thereof, as recorded in Plat Book 2, Page 85 of the Public Records of Hillsborough County, Florida of which Pinellas County was formerly a part. REG. 0 0012 Page 2 STEWART TI~'lI...I~ GUARANTY COMPANY AL T A OWNER'~ POLICY Order No. 91060110 I I SCHEDULE B 2111 Policy No.: O-n~-16650 This policy does not insure against loss or damage by reason of the following: delete1. 1}lj~~SUCK~~~tt:*'x.~~~lOOt~~~RR~~ delet~. ~IllKaOODxISKK~Jl!meot~P{~g. delete3. EnomE;&mmeotK)Cm~~nN5XlSig~Kil(Q~pmxMf19't~~~Wffi~~~P@C~~X(Ji~{q~ ~iec~iospex:iilOXI~KI!lS. delet~. A~xiooc~kx}6(~XlHIDliooopd2mm~xoox~~}ftef5KM5JC~Ml~d, i~~J1ho~k!.wca~~ltktr~mxds. deletE5.x~:pm~5~~~~~iC~~~~~~lC~N~t~ptka:N~)ci!fc~of tR~~X delet~. An)lotKmsclO[xN~~~WOC~~~~~~~:lq~:Xlf~WCKtIll~xoanpcKlI1tilOmqc g~RKIeOtxxomclOtme.IOeatXlms\x1Ootidecxml!tg,x:m:x:lmIld6x&m~~~~XIllR~~f nCN~X~~~!lUCJgtKjpondm:ld5xm~~Jl!xliJm:xXxItrexR:auOOoonc~x lin~~~~R~~leXbmilt:~abat:a:be6~m~~KK~Y. 7. Taxes for the year 19 92 and thereafter. 2113 Page 3 STEWART TITLE GUARANTY COMPANY ) _____r .,.. _ ~ ,_ -- - - ~ -. --....... -"..~ tONDITIONS AND STIPULATIONS ContinueJ (continued and concluded from reverse side of Policy Face) > .. - (0) 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. (2) (This paraQraph 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. AII/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 B or to which the insured has agreed, ossumed, 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 OFLOSS. (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 satisfaction of the Company. (b) When liability and the extent of loss or damage has been definitely fixed in accordance with these Conditions and Stipulations, the loss or damage shall be payable within 30 days thereafter. 13. SUBROGATION UPON PAYMENT OR SETTLEMENT. (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 c1aimont 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 transter 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 shall permit the Company to sue, compromise or settle in the name of the insured c10imant and to use the name of the insured claimant in any transaction or litigation involving these rights or remedies. If a payment on occount 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 Iimitotion, 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: ance Arbitration Rules of the American Arbitration Association may be demanded if aQreed 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 arisinQ out of or relatina to this policY, any service of the Company in connection with its issuance or the breach of a policy provision or other obliQation. 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 bindinQ 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 prevailinQ party. JudQment upon the award rendered by the Arbitrator(sl may be entered in any court havinQ jurisdiction thereof, The law of the situs of the land shall apply to an arbitration under the Title Insurance Arbitration Rules. A copy of the Rules may be obtained from the Company upon request. 15. 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 signotory 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 ony 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 . STEWART TITLE GUARANTY COMPANY ESTABLISHED 1896 INCORPORATED 1908 A NAME RECOGNIZED NATIONALLY FOR MORE THAN 80 YEARS AS BEING SYNONYMOUS WITH SAFETY ,~~ - -- - --- -- -+-- --- - --- ---- .....~ " SanClily of ConrraCl STEWART TITLE GUARANTY COMPANY P. O. Box 2029 Houston, Texas 77252 ~ POLICY OF TITLE INSURANCE \~ ,