GEORGE STONE (2)
1"'"'\-,
I"', ...,;
- i"cturn to:. (enclos(~ self-addressed starrled envelope)
!Name: ~TEWAR'F TITLE OF CLI<;A~ATER, INC.
Address: 1290 Court Street
Clearwater, Florida 33756
This Instrument Prepared by: MARIANNE. SCHAFFER
of STEWART TITLE OF CLEARWATER, INC.
as a necessary incident to the fulfillment of conditions
contained in a title insurance commitment issued by it.
Property Appraisers Parcel Identification (Folio) Number(s): ,_
15-29-15-00000-210-0700 ~
Grantee(s) 5,5,II(s):
FILE NO:
I 999 2: 18ptl
N- 8-1 G 188
99-188793 5U eK 10545 ?
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n'he terms -gral1lor- and -grantee- herein shall be construed to include ,II genders aoo siltlu11r or plural as the conlelt inclte'les,)
This Warranty Deed Made this l!L-day of May A,D,19 99 , by
~ GEORGE W. STONE, TRUSTEE of the J. O. STONE GRANDCHILDREN'S
r'P'~~:,~~_---"."'TR,. UST under Trust Agreement dated December 29th., 1976 , f/h/o MAt'\( FORESTER
II, . \ /"' IlI,,\
r~'\,.,\,J, '."-,l-~'-~-~
DP;:;1~; ~. j'rihose marital status is: ,
,;..;,Jt!T hereinafter called the grantor, whose post office address IS:
1.... _ ,_ '
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to CITY OF CLEARWATER, FLORIDA, a Florida Municipal Corporation
F'."',
, .
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whose post office address is: P. O. Box 4748, Clearwater, Florida 33758-4748
~~\-Hi~.3 J.1:er~nafter called the grantee.
C:.";<.: '\ ,', WITNESSETH: That said grantor, for and in consideration of the sum of $10,00 Dollars, and other valuable considerations.
.in'~, I'.; iY"'" receipt whereof is hereby acknowledged, h,ereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the
grantee, all that certain land situate in P lne lIas County. Florida. viz:
L~GAL D~SCRIPTION:
A PARCEL OF LAND BEING A PORTION OF THAT CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL RECORDS
BOOK 9956, PAGE 1415 OF THE PUBLIC RECORDS OF PINELLAS COUNTY. FLORIDA. LYING WITHIN THE WEST 1/2 OF
THE NORTHEAST 1/4 Of THE NORTHWEST I/~ OF SECTION IS, TOWNSHIP 29 SOUTH. RANGE IS EAST, CITY OF
CLEARWATER. PINELLAS COUNTY. FLORIDA, BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS:
CCMv'ENCE AT THE SOUTHlVEST CORNER Of THE NORTHEAST 1/4 OF THE NORTIfNEST 1/4 OF SECTION IS, to'NNSHIP
29 SOUTH. RANGE 15 EAST. CITY Of CLEARWATER. PINELLAS COUNTY. FLORIDA; THENCE S 89.'2'05' E, ALONG
THE SOUTH BOUNDARY LINE OF SAID NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION 15 (BEING THE BASIS OF
BEARINGS FOR THIS DESCRIPTIONl. FOR 665.46 FEET TO THE SOUTHEAST CORNER OF THE WEST 1/2 OF SAID
NORTHEAST 1/4 OF THE NORTHVtf:ST 1/4 Of SECT ION 15, SAME ALSO BE ING THE SOUTHEAST BOUNDARY CORNER OF
THAT CERTAIN PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 99S6. PAGE 1415 OF THE PUBLIC
RECORDS or PINELLAS COUNTY. FLORIDA. SAM:: ALSO BEING THE SOUTHEAST BOUNDARY CORNER OF THAT CERTAIN
PROPERTY AS DESCRIBED IN OFFICIAL RECORDS BOOK 3219. PAGE 346 Of THE PUBLIC RECORDS OF PINELLAS
COUNTY, FLORIDA: THENCE LEAVING SAID SOUTH BOUNDARY LINE Of THE NORTHEAST 1/4 OF THE NORTHWEST 1/4
or SECTION 15. N 00.00'08" W, ALONG THE EAST BOUNDARY LINE Of. SAID WEST 1/2 OF THE NORTHEAST 1/4 OF
THE NORTHWEST 1/4 Of SECTION 15. SAME ALSO BEING THE EAST BOUNDARY LINE OF SAID CERTAIN PROPERTY AS
DESCRIBED IN OFFICIAL RECORDS BOOK 32'19. PAGE 346, SAME ALSO BEING THE EAST BOUNDARY LINE Of SAID
CERTAIN PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 99~6. PAGE 1415. FOR ~2.68 FEET TO
THE NORTHERN MOST BOUNDARY CORNER OF SAID CERTAIN PROPERTY AS DESCRIBED IN OfFICIAL RECORDS BOOK
3219, PAGE 346, SAME ALSO BEING THE POINT OF BEGINNING: THENCE CONTINUE N 00.00'08" W, ALONG SAID
EAST BOUNDARY LINE Of THE WEST 1/2 OF THE NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION 15, SAM(
ALSO BEING SAID EAST BOUNDARY LINE OF THAT CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL
RECORDS BOOK 9956. PAGE 1415, FOR 111.84 FEET TO THE NORTHEAST BOUNDARY CORNER OF SAID CERTAIN
PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL RECORDS BOOK 9956, PAGE 1415, SAME ALSO BEING THE
SOUTHEAST BOUNDARY CORNER Of THAT CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK 915. PAGE 103 Of THE
PUBLIC RECORDS Of PINELLAS COUNTY. FLORIDA; THENCE LEAVING SAID EAST BOUNDARY LINE Of THE WEST I/Z
OF Tl-iE NORTHEAST 1/4 OF Tl-E NORTI-ft'EST 1/4 OF SECTION IS, N 89.ll'OS" W. ALONG THE NORTH BOUNDARY
LINE OF SAID CERTAIN PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 99S6. PAGE 1415. SAME
ALSO BEING THE SOUTH BOUNDARY LINE Of SAID CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK 915. PAGE 103.
FOR 4,70 FEET TO THE SOUTHW[ST BOUNDARY CORNER OF SAID CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK
91~. PAGE 103: THENCE LEAVING SAID NORTH BOUNDARY LINE OF SAID CERTAIN PROPERTY DESCRIBED AS PARCEL
I I IN OFFICIAL RECORDS BOOK 9956, PAGE 1415. S 03.08'S6" W. FOR 164.64 FEET TO THE NORTHEAST
BOUNDARY CORNER OF LOT I, REVISED MAP OF R.H, PADGETT'S SUBDIVISION. AS RECORDED IN PLAT BOOK 4,
PAGE 32 OF THE PUBLIC RECORPSQfPINELLAS COUNTY.. FLORIDA, SAME ALSO BEING THE POINT or INTERSECTION
WITH THE SOUTH BOUNDARY LINE OF SAID CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL RECORDS
BOOK 9956, PAGE 1415. SAME ALSO BEING AFORESAID SOUTH BOUNDARY LINE Of THE NORTHEAST 1/4 OF THE
NORTHWEST 1/4 ~ SECTION IS: THENCE S 89" 12'0~" E. ALONG SAID SOUTH BOUNDARY LINE Of THE NORTHEAST
1/4 OF THE NORTHWEST 1/4 OF SECTION 15. SAME ALSO BEING SAID' SOUTH BOUNDARY LINE OF SAID CERTAIN
PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 99S6. PAGE 1415. FOR S.05 FEET TO THE
SOUTHWEST BOUNDARY CORNER OF AFORESAID CERTAIN PROPERTY AS DESCRIBED IN OFFICIAL REvORDS BOOK 3219.
PAGE 346: THENCE LEAVING SAID SOUlH BOUNDARY LINE OF THE NORTHEAST 1/4 OF THE NQRTHWrST 1/4 OF
SECTION IS. N 09"23'450 E. ALONG THE WEST BOUNDARY LINE OF SAID CERTAIN PROPERTY AS DESCRIBED IN
OFFICIAL RECORDS BOOK 3219. PAGE 346. FOR 53,Z7 FEET TO THE POINT Of BEGINNING AND CONTAINING \.289
SQUARE FEET OR 0,0296 ACRES. MORE OR LESS.
See attached Exhibit "A" hereto
Page 1 of 2
~ ~0~
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I
IINELLAS COUNTY FLA,
OFF ,REC,8K 10545 PG 189
This property [0(1 [is not] the homestead of the,Grantor(s).
TOGETHER with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining,
To Have and to Hold, the same in fee simple forever,
And the grantor hereby covenants with said grantee that 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; that the grantor hereby fully warrants the title to said land 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 31, 19 99, reservations, restrictions and easements of record, if any,
IN WITNESS WHEREOF, Grantor has hereunto set grantor's hand and seal the day and year first above written,
< ttjJ~.
(Seal)
TRUSTEE
(Seal)
Witness Signature:
Witness Printed Name:
(Seal)
Witness Signature:
Witness Printed Name:
(Seal)
STATE OF FLORIDA
COUNTY OF Pinellas
The foregoing instrument was acknowledged before me this N~ day of May , 19 99
by GEORGE W. STONE, TRUSTEE of the J. O. STONE GRANDCHILDREN'S
TRUST under Trust Agre~ent dated December 29th., 1976, f/bla MAX FORESTER
who is/are personally known to me or who haslhave produced driver license(s) as identification,
Printed Name:
Notary Public
Serial Number:
~
, My Commission expires:
~~
~~..,"
... ~
o _
z: n
DEBRA A. BORGH
Notary Public, State 01 Florida
lAy Commilsion Expire. Jan. 30, 2001
Commluion . CeSllna?
STATE OF
COUNTY OF
The foregoing instrument was acknowledged before me this
by
day of
. 19
who is/are personally known to me or who haslhave produced driver license(s) as identification,
My Commission expires:
Printed Name:
Notary Public
Serial Number:
8C080941 06-08-1999
01 0000000000
DED-CLWR
RECORDING 003 PAGES
DOC STA"P - DR219
14:18:11
JI'lF
1
3
TOTAL:
P CHECK A"T. TENDERED:
CHANGE:
$15.00
$16.10
--------
$31.10
$31.10
$.00
Page 2 of 2
l-
PINELLAS COUNTY rLA,
Orr ,REC,8K 10545 PG 180
-,
THERE MAY BE ADDITIONAL RESTRICTIONS AFFECTING THIS PROPERTY THAT
MAY BE fOUND IN THE PUBLIC RECORDS Of tHIS COUNTY.
THIS LEGAL DESCRIPTION AND SKETCH WAS PREPARED WITHOUT THE BENEFIT
OF A TiTlE POLICY.
BEARINGS ARE BASED UPON, SEE SKETCH AND LEGAL DESCRIPTION
Z
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OF THE NE 1/4
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Of SEC 15-29S-15E
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(BEARING BASIS)
S BNOY UNE OF' TH NE 1/4
OF' THE NW 1/4 OF SECTION 15-29S-15E
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OR - 0ffIc:IaI Recorda Book
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PARCEL "
OR 9956, PG 1415
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r AREA =
S03'08'56.W
53.27' 111.84'
---
52.68' P08
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..
58912'05-E
5.05'
11289 SF OR 0.0296 AC %
N8912'05.W
4.70'
NOg '23'45.t
\ R/W
OR 321'. PG ~_ _
NOO'OO'oa.W
164.64'
_r-f.OO-oO'OS.W _ _ _
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/W PElt os 91~. PG 10J
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PB H4 PG 99
MADISON AVENUE
WI
.
ltll
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i!.'~
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SE COR or THE W 1/2 E UNE or THE W 1/2 OF THE
Of THE NE 1/. OF ll-lE NE 1/4 or THE NW 1/. OF
NW 1/4 or SEe 1S-29S-1SE SEcnON 15-29S-1SE .
CLEARWA TER HEIGHTS
PLA T BOOK H4, PAGE 99
THS LECAL. AND SI<(T04 ...~ PRO'AAED NTH THE IlOIUlT ~ A R1CHT-~-WAY ~ TOPOGRAPHIC SJRVEY PREPAA(D BY FtORIOA OESICN CONSUl'!ANTS,. INC..
nn.m "WAOlSON A~NUE/GOUU) STREIT"'. JOe No. 117-02. lAST DAl[ ~ FlElJ) WORK 7/21/1998 AND DAl[ S~ED 8/27/199&.
PRD>AAm fOlt;
son, DE SCRIPllON:
SCAlL:
r' = 30'
jJ08 ~
197 -02
THE CITY OF CLEARWATER, FLORIDA
SKETCH
DATE: ORA~ J J
9/0211998 LCS Jt"
S[ C11ON:
I hereby Clrflf7 Ihot thl. legal dllcrlplion and .ketch
mul. Ihl minImum tlChnical .Iandord. a. lit forth
by Ihe Florida Boord of Professionol Land Surveyor.
In Chapler 61G17-6 Florido Admini.trallve Code,
pursuanl 10 Section 472.027, Florida $Ialul..
NOT VALID WITHOUT THE SIGNATURE
AND THE ORIGINA RAISED SEAL OF A FLORIDA
lICENS URVEY R AND MAPPER.
CER D A 0 GAL ESCRIPTION AND SKETCH
CAlcn III
LCS ,...,.. RCW
TOllN9i1P: RAHCE:
29 5 15 E
15
FLORJ)A DESIGN CONSU.TANT8, NO.
ENG~EERS. ENVmONMENTAl~TS
SURVEYORS 8 PLANNERS
2639 McCo'IIlick D,iu
Cleo,.o'tr. F'lorou 3J7~'
(727) 724-8422
Certlflcate of Authorization: L8 6707
Stotl'! nf F'1,..,.I.4...
C. WRIGHT. JR.
PROFESSIONAL SURVEYOR AND MAPPER
lICEN..S.E_!lU~~~~_ LS ~6;) $lATE OF FLORIDA
-,
~
I
I
PURCHASE AGREa11 FOR R~~:;OF-:::JECT : MADISON AVENUE
Ge~~ Stone', JjIA
THIS AGREEMENT is made between a:7'==@7'==S=t:6Tl€=, as Trustee FBO Jody Forester
U/T/A dated December 29, 1976, owner and holder as tenant in common of an
undi vided 25% interest in subj ect real property; and as Trustee FBO Max
Forester U/T/A dated December 29, 1976, owner and holder as tenant in common
of an undivided 25% interest in subject real property, (herein, collectively,
"Seller"), c/o Charles F. Barber, Esquire, 1550 South Highland Avenue, Suite
B, Clearwater, Fl. 33756, and the CITY OF CLEARWATER, FLORIDA, a Florida
Municipal Corporation, 112 South Osceola Avenue, Clearwater, Fl. 33756 herein
("Buyer" or "City").
WITNESSETH
For and in consideration of the mutual covenants and conditions herein
contained, Seller hereby agrees to sell and Buyer agrees to buy the following
property or interest therein, upon the following terms and conditions:
I. DESCRIPTION
Real estate or interest
depicted in EXHIBIT "A",
made a part hereof.
therein,
Pages 1
identified as legally described and
and 2 which are attached hereto and
INTEREST BEING ACQUIRED: [X] Fee simple
Personal property to be conveyed: None
[ ] Easement
II. CONSIDERATION
Amount to be paid by Buyer to Seller ln cash at closing. . . .$9,023.00
III. CONDITIONS AND LIMITATIONS
(a) It is mutually understood and agreed that this Agreement is
executed by the Seller subject to final approval and acceptance by
the Clearwater City Commission, which shall occur within forty-five
45) days of receipt of this document by Earl Barrett, Real Estate
Services Manager in the Clearwater Public Works Department,
together with counterpart agreements from all other parties having
fee interest in the property described herein. Date of acceptance
and execution by duly authorized officers of the City shall be the
Effective Date of this agreement, and execution shall serve to
ratify and confirm the purchase price and all terms and conditions
as are contained herein. If this agreement is not timely accepted
and executed by the City, Seller may, at Seller option, withdraw
from this agreement by providing written notice of such intent to
the office of the City Attorney, whereupon this agreement shall
thereafter be null and void in all respects.
(b) No actual or estimated ad valorem taxes shall be prorated to
the City or collected from Seller at time of closing this
transaction. The City shall pay state documentary stamps to record
deed given in this transaction.
p'.
1
I
I
Page 2 - Madison Avenue (Stone Buick parcel)
(c) The Buyer shall designate a closing agent located in Pinellas
County, Florida, and this transaction shall be closed in the
offices of the designated closing agent. Seller shall deliver
unencumbered title to the City at closing; however, the City shall,
at City's sole cost and expense, have the obligation to obtain any
releases of encumbrances as the City may require, together with
title insurance and certified parcel survey.
(d) The City agrees to restore to the present or equal condition any of
Seller1s remainder property up to but not more than five feet (5')
abutting the parcel being conveyed that may be disturbed or
impacted during construction of contemplated right-of-way
improvements. Such restoration shall be accomplished at City
expense and shall be completed not later than project completion.
IV. CLOSING DATE - POSSESSION
This transaction shall be closed and the Seller shall convey title by
Special Warranty Deed within sixty (60) days of the Effective date of
this agreement.
V. TYPEWRITTEN OR HANDWRITTEN PROVISIONS
Typewritten or handwritten provisions inserted herein or attached
hereto as addenda, and initialed by the parties, shall control
all printed provisions in conflict therewith.
VI. COUNTERPARTS; FACSIMILE COPY
This agreement may be executed in two or more counterparts, each of
which shall be deemed an original and all of which together shall
constitute one instrument. A facsimile copy of this agreement,
including any addenda, attachments and any written modifications hereof,
and any initials or signature thereon shall be deemed an original.
VII. IN WITNESS WHEREOF, the Seller has caused these presents to be
executed this ~ day of -;1~n~ ' 1991t.
SELLER:
(~~.
l'i'e7-=:f!:Pfi~
Stone, Trustee
...,
I
1
Page 3 - Madison Avenue (stone Buick parcel)
VI. FINAL ACCEPTANCE BY THE CITY OF CLEARWATER, FLORIDA, EFFECTIVE DATE.
IN WITNESS WHEREOF, the City of Clearwater, Florida has caused these
presents to be approved and accepted by its City Commission, and executed In
its name by its officers thereunto duly authorized this ~day of
~ ' 1999.
-~ \
BUYER:
OF CLEARWATER, FLORIDA
CITY
~
....
By:
Michael J. Roberto, City Manager
Approved as to form
and correctness:
Attest:
~~
John Carassas
Assistant City Attorney
Stone Buick ROW Contr,l198Bewb
..
,
nitS IS HQI A SUR~ EXHIElT "An - Paae 1 of 2
THERE MAY BE ADDITIONAL RESTRICTIONS AfFECTING THIS PROPERTY THAT
MAY BE FOUND IN THE f>UBlIC RECORDS OF THIS COUNTY,
THIS LEGAL DESCRIPTION AND SKETCH WAS PREPARED WITHOUT THE BENEFIT
OF A TITLE POLICY,
BEARINGS ARE BASED UPON, SEE SKETCH AND LEGAL DESCRIPTION
LEGAL DESCRIPTION:
A PARCEL OF LAND BEING A PORTION OF THAT CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL RECORDS
BOOK 9956, PAGE 1415 OF THE PUBLIC RECORDS OF PINELLAS COUNTY. FLORIDA, lYING WITHIN THE WEST 1/2 OF
THE NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION I~, TOWNSHIP 29 SOUTH. RANGE 15 EAST. CITY OF
CL~ATER. PINELLAS COUNTY. FLORIDA. BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS:
COMMENCE AT THE SOUTHWEST CORNER OF THE NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION 15. TOWNSHIP
29 SOUTH. RANGE 15 EAST. CITY OF CLEARWATER. PINELLAS COUNTY. FLORIDA; THENCE S 89012'05' E, ALONG
THE SOUTH BOUNDARY LINE OF SAID NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION 15 (BEING THE BASIS OF
BEARINGS FOR THIS DESCRIPTION), FOR 665,46 FEET TO THE SOUTHEAST CORNER OF THE WEST 1/2 OF SAID
NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION 15. SAME ALSO BEING THE SOUTHEAST BOUNDARY CORNER OF
THAT. CERTAIN PROPERTY DESCRIBED AS PARCEL 1 I IN OFFICIAL RECORDS BOOK 9956, PAGE 1415 OF THE PUBLIC
RECORDS OF PINELLAS COUNTY. FLORIDA. SAME ALSO BEING THE SOUTHEAST BOUNDARY CORNER OF THAT CERTAIN
PROPERTY AS DESCRIBED IN OFFICIAL RECORDS BOOK 3219, PAGE 346 OF THE PUBLIC RECORDS OF PINELLAS
COUNTY, FLORIDA; THENCE LEAVING SAID SOUTH BOUNDARY LINE OF THE NORTHEAST 1/4 OF THE NORTHWEST 1/4
OF SECTION IS, N 00000'08" W, ALONG THE EAST BOUNDARY LINE OF SAID WEST 1/2 OF THE NORTHEAST 1/4 OF
THE NORTHWEST 1/4 OF SECTION 15. SAME ALSO BEING THE EAST BOUNDARY LINE OF SAID CERTAIN PROPERTY AS
DESCRIBED IN OFFICIAL RECORDS BOOK 3219. PAGE 346, SAME ALSO BEING THE EAST BOUNDARY LINE OF SAID
CERTAIN PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 9956, PAGE 1415. FOR 52.68 FEET TO
THE NORTHERN MOST BOUNDARY CORNER OF SAID CERTAIN PROPERTY AS DESCRIBED IN OFFICIAL RECORDS BOOK
3219. PAGE 346, SAME ALSO BEING THE POINT OF BEGINNING; THENCE CONTINUE N 00000'08" W. ALONG SAID
EAST BOUNDARY LINE OF THE WEST 1/2 OF THE NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION 15. SAME
ALSO BEING SAID EAST BOUNDARY LINE OF THAT CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL
RECORDS BOOK 9956. PAGE 1415. FOR I I I ,84 FEET TO THE NORTHEAST BOUNDARY CORNER OF SAID CERTAIN
PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 9956, PAGE 1415, SAME ALSO BEING THE
SOUTHEAST BOUNDARY CORNER OF THAT CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK 915. PAGE 103 OF THE
PUBLIC RECORDS OF PINELLAS COUNTY. FLORIDA: THENCE LEAVING SAID EAST BOUNDARY LINE OF THE WEST 1/2
OF THE NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION IS, N 890IZ'OS" W. ALONG THE NORTH BOUNDARY
LINE OF SAID CERTAIN PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 9956. PAGE 1415. SAME
ALSO BEING THE SOUTH BOUNDARY LINE OF SAID CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK 915. PAGE 103,
FOR 4.70 FEET TO THE SOUTHWEST BOUNDARY CORNER OF SAID CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK
91~. PAGE 103: THENCE LEAVING SAID NORTH BOUNDARY LINE OF SAID CERTAIN PROPERTY DESCRIBED AS PARCEL
I t IN OFFICIAL RECORDS BOOK 9956. PAGE 1415. S 03008'56" W. FOR 164,64 FEET TO THE NORTHEAST
BOUNDARY CORNER OF LOT I, REVISED MAP OF R,H, PADGETT'S SUBDIVISION. AS RECORDED IN PLAT BOOK 4,
PAGE 32 OF THE PUBLIC RECORDS OF PINELLAS COUNTY. FLORIDA. SAME ALSO BEING THE POINT OF INTERSECTION
WITH THE SOUTH BOUNDARY LINE OF SAID CERTAIN PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS
BOOK 9956, PAGE 1415, SAME ALSO BEING AFORESAID SOUTH BOUNDARY LINE OF THE NORTHEAST 1/4 OF THE
NORTHWEST 1/4 OF SECTION I~: THENCE S 89012'05. E. ALONG SAID SOUTH BOUNDARY LINE OF THE NORTHEAST
1/4 OF THE NORTHWEST 1/4 OF SECTION 15. SAME ALSO BEING SAID SOUTH BOUNDARY LINE OF SAID CERTAIN
PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 9956. PAGE 1415. FOR 5,05 FEET TO THE
SOUTHWEST BOUNDARY CORNER OF AFORESAID CERTAIN PROPERTY AS DESCRIBED IN OFFICIAL RE~ORDS BOOK 3219.
PAGE 346: THENCE LEAVING SAID SOUTH BOUNDARY LINE OF THE NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF
SECTION 15. N 09023'45" E. AlONG THE WEST BOUNDARY LINE OF SAID CERTAIN PROPERTY AS DESCRIBED IN
OFFICIAL RECORDS BOOK 3219. PAGE 346. FOR 53.27 FEET TO THE POINT OF BEGINNING AND CONTAINING 1,299
SOUARE FEET OR O,OZ96 ACRES. MORE OR LESS. CLOSURE: 0,0018'
THIS ILeAL AND S1<ETOi WAS PREPARED""" 1HE fl(NEm' ~ A RlQiT-~-WAY AND TOPOCRAPltC gjR'v'[Y PREPARED BY Fl~DA DESIGN CONSULTANTS. INC..
mUD ~SON A'JENUE/GOULO ~. JOB No. 187-<12. lAST DATE OF F1El.o WORK 7/21/1998 AND DATE SIGNED a!27/1i8&.
PR[P ARED 'OR:
SHEET DESCRlPT1ON:
THE CITY OF CLEARWATER, FLORIDA
LEGAL DESCRIPTION
CAlcm u J
lCS ~
TOWCSHP:
SCAU:
N/A
OA TE: ORA Me
9/0211998 LCS
SEClICH:
04E
197 -02
15
29 5
15 E
I hereby certify that this 'egal description and .ketch
muts the minimum technicClI .tandard. o. III forth
by thl Florida Boord of Professional Land Surveyor.
in Chopter 61G17.6 Florida Administratlvl COdl,
pursuant 10 Section 472.027, Florida Slatul..
NOT VALID WITHOUT THE SIGNATURE
AND THE ORIGIN RAISED SE~l OF A FLORIDA
CENSE URV R AND MAPPER.
AS DESC~IPTI N AND SKETCH
JOB No.:
R.ORDA DESIGN CONSlI.TANTS, fie.
ENGINEERS, ENVIRONMENT AlIS TS
SURVEYORS 8 PLANNERS
2639 McCormick Driv.
Cloarwalor, Florido 33 7~9
(727) 724-8422
~rtlncate of Authorization: LB 6707
State of florida
ROBERT C. WRIGHT. JR.
PROFESSIONAL SURVEYOR AND MAPPER
LICENSE NUMBER LS 4 5 S TE OF FLORIDA
DA TE SIGNED,
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lHIS IS l:<<U A SUR~ EXHI IT "A" - Paae 2 of 2
THERE MAY BE ADDITIONAL RESTRICTIONS AFFECTING THIS PROPERTY THAT
MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY.
THIS LEGAL DESCRIPTION AND SKETCH WAS PREPARED WITHOUT THE BENEFIT
OF A TITLE POLICY.
BEARINGS ARE BASED UPON, SEE SKETCH AND LEGAL DESCRIPTION
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Of SEC 15-29S-15E
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OF THE NW 1/4 OF SECTION 15-29S-15E
NOT PLA TIED
PARCEL II
OR 9956, PG 1415
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MADISON AVENUE
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SE COR OF THE W 1/2 E LINE OF THE W , /2 OF THE
OF THE NE 1/4 OF THE NE 1/4 OF THE NW 1/4 OF
NW 1/4 OF SEC 15-29S-15E SECTION 15-29S-15E ,r
CLEARWA TER HEIGHTS
PLAT BOOK H4, PAGE 99
lHS LEGAl AND SXETCH 'M"5 PREPARED MlloI lloIE BENEFIT Of A RIGHT-Of-WAY AND TOPOGRAPHIC SJRVEY ~AA(D BY FlORIOA DESIGN CONSULTANTS, INC.,
nTl..ED "'AOlSON A~NUE/GOULD STREEr, JOB No. 197-02, LAST DAlE Of FIELD WORK 7/21/1998 AND DAlI SIGNED 8/27/1991.
PRO' ARt]) FOR;
SIiEl:.,. DE SCRIPltON:
$CALL:
I" =
30'
JOB ~
197- 02
THE CITY OF CLEARWATER, FLORIDA
SKETCH
DATE: DRAWN: J I
9/02/1998 LCS ~
SE C1tOH:
CAlero: tll
LCS f\I--
TOllNSHIP:
I hereby certify that this legal description and sketch
meet. the minImum technical .tandard. a. ut forth
by the Florida Boord of Professional Lond Surveyors
In Chapter 61G17-6 Florida Administrative Code,
pursuant 10 Seeflon 472.027, Florida Statut..
NOT VALID WITHOUT THE SIGNATURE
AND THE ORIGINA RAISED SEAL OF A FLORIDA
LICENS URVEY R AND MAPPER.
CER D A 0 GAL ESCRIPTION AND SKETCH
RCW
ItAHC(:
15 E
15
29 5
FLORf)A DESIGN CONsu. TANTS, NC.
ENGINEERS, ENVIRONMENT AlIS TS
SURVEYORS a PLANNERS
2639 McCormick Drive
Cleorwoler. 1'10"40 J37~9
(727) 724-8422
Certificate of Authorization: L8 6707
State of Florida
C. WRIGHT, JR.
PROFESSIONAL SURVEYOR AND MAPPER
LICENSE NUMBER LS ,is, ~ $lATE OF FLORIDA
DATE SIGNED, 7' '-7V
AL TA OWNER'S POLICY - 10-17-92 WITH FLORIDA MODIFICATIONS
"If you want information about coverage or need assistance to resolve complaints, please call 1-800-729-1902,
you must furnish written notice in accordance with Sfction 3 of the CO~ditions a~d Stipulations,"
Visit our World-Wlde'Web Slite at: httO:llwww.stewarlom I
-
If you make a claim under your policy,
POLICY OF TITLE INSURANCE ISSUED BY
99010086
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STEWART TITLE
GUARANTY COMPANY
SUBJECT TO THE EXCLUSIONS FROM COVERAGE. THE EXeEPTIONS FROM COVERAGE CONTAINED IN
SCHEDULE B AND THE CONDITIONS AND STIPULATIONS. STEWART TITLE GUARANTY COMPANY, a Texas
corporation. herein called the Company. insures. as of Date of Policy shown in Schedule A, against loss or damage, not
exceeding the Amount of Insurance stated in Schedule A, sustained or incurred by the insured by reason of:
1, Title to the estate or interest described in Schedule A being vested other than as stated therein;
2, Any defect in or lien or encumbrance on the title;
3, Unmarketability of the title;
4, Lack of a right of access to andfrpmtheJapd,
The Company will also pay the costs, stlorneys~'fe8ijnd!j.._.A!tcur. in defense of the title, as insured. but only
to the extent provided in the Conditions and Stipulations.
IN WITNESS WHEREOF, Stewart Title Guaranty Company has caused this policy to be signed and sealed by its
duly authorized officers as of the Date of Policy shown in Schedule A.
4'
STEWART TITLE
GtJ:UIA.NTY COMJ>ANY
Company
City, State
EXCLUSIONS FROM. COVERAGE
The following matters are expressly excluded from the coverage of this policy and the Company will not pay loss or damage, costs, attorneys' fees or
expenses which arise by reason of:
1. (a) Any law, ordinance or governmental regulation (including but not limited to building and zoning laws, ordinances, or regulations) restricting,
regulating, prohibiting or relating to (i) the occupancy, use, or enjoyment of the land; (ii) the character. dimensions or location of any improvement now or
hereafter erected on the land; (iii) a separation in ownership or a change in the dimensions 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 violation of these laws, ordinances or govemmental regulations. except to the extent that a notice 0
the enforcement thereof or a notice of a defect, lien or encumbrance resulting from<.i violation or alleged violation affecting the land has been recorded in th
public records at Date of Policy,
(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; f
(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 t
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; t
(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 t
bankruptcy, state insolvency, or similar creditors' rights laws, that is based on:
(a) the transaction creating the estate or interest insured by this policy being deemed a fraudulent conveyance or fraudulent transfer; or f
(b) the transaction creating the estate or interest insured by this policy being deemed a preferential transfer except where the preferential transfer results
from the failure: t
(i) to timely record the instrument of transfer; or
(ii) of such recordation to impart notice to a purchaser for value or a judgment or lien creditor,
---------
Page 1 of 0 2125
Policy _ _
Senal No,
234766
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1- BJI
SCHEDULE A
FILE NO,
POllCY NUMBER
DATE OF POllCY
June 08, 1999
2:17 PM
AMOUNT OF INSURANCE
99010086
0-2125-234766
1$9.023.00
1 Name of Insured:
CITY OF CLEARWATER, FLORIDA, a Florida Municipal Corporation
2. The estate or interest ill the land which IS covered by this Policy IS:
FEE SIMPLE
3 Title to the estate or interest In the land IS vested In the Insured.
4. The land referred to In this policy IS described as follows:
For Company reference Purposes Only
According to insured representation or vesting instrument(s), the street address of the property IS:
Street Name:
City/State/Zip:
County: Pinellas Pin/Tax #: 15-29-15-00000-210-0700
The Company does not represent or insure the above address IS accurate
STEWART TITLE
Reg, D 0012 Rev, 11-91
GUARANTY COMPANY
1- I
Policy Number: 0- 2125-234766
File No: 99010086
SCHEDULE B
This policy does not insure against loss or damage by reason of the following:
1. Rights or claims of parties in possession not shown by the public records.
2. Easements, or claims of easements, not shown by the public records.
3. Encroachments, overlaps, boundary line disputes, or other matters which would be disclosed by an accurate survey
and inspection of the premises.
4. Any lien, or right to a lien, for services, labor, or material heretofore or hereafter furnished, imposed by law and
not shown by the public records.
5. Community property, dower, curtesy, survivorship, or homestead rights, if any, of any spouse of the insured.
6. Any titles or rights asserted by anyone including but not limited to persons, 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.
7. Taxes for the year 1999 and thereafter and assessments, if any, not recorded in the public records.
8. Subject to any lien for municipal improvements or services to
captioned land which has not been filed for record in the office
of the Clerk of the Circuit Court of Pinellas County, Florida,
and any and all outstanding assessments projected or to be
projected, if any.
9. Any lien provided by Chapter 159 of Florida Statutes in favor
of any city, town, village or port authority for unpaid service
charges for service by any water system, sewer system or gas
system servicing the land described herein.
10. Subject to zoning and/or other governmental prohibition or
regulations affecting the use of the property.
11. Title to any furniture, furnishings, fixtures, or chattels or
personal property located in, to or upon the land described in
Schedule "A" hereof.
12. Subject to unrecorded leases and/or options to purchase
affecting subject premises.
13. If subject property has been a rental unit or non-owner occupied
property, it may be subject to Tangible Taxes, which are not
covered by this policy.
Exceptions numbered
1 and 4
are hereby deleted from the Owners Policy.
LE.GAL Ot:SCR 1 P.11 ON: I I
A PARCEl OF LAND BEING A PORTh... ~ THAT CERTAIN PROPERTY DESCRIBED ,is PARCEL II IN OF;'ICI6iL 'RECORDS
BOOK ~56: ~AGE 1415 OF THE PUBLIC RECORDS or PINELLAS COUNTY, FLORIDA, LYING WITHIN THE WEST 1/2 OF
THE NORTHEAST 1/4 ~ THE NORT~ST II" OF SECTION 15, Tatr'NSHIP 29 SOUTH, RANGE 15 EAST, CITY OF
,CLEARWATER, PINELLAS COUNTY, FLORIDA, BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS:
CCMwENCE AT THE SOUTmiEST CORNER ~ THE NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION 15, TOWNSHIP
29 SOUTH, RANGE 15 EAST, CITY OF CLEARWATER, PINELLAS COUNTY, FLORIDA; THENCE S 89.'2'05' E, ALONG
THE SOUTH BOUNDARY LINE Of SAID NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION 15 (BEING THE BASIS OF
BEARINGS FOR THIS DESCRIPTION), FOR 665.46 FEET TO THE SOUTHEAST CORNER OF THE WEST 1/2 Of SAID
NORTHEAST 1/4 OF THE NORT~ST 1/4 OF SECT I ON 15, SAME ALSO BE I NG THE SOUTHEAST BOUNDARY CORNER OF
THAT CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL RECORDS BOOK 9956, PAGE 1415 OF THE PUBLIC
RECORDS or PINELLAS COUNTY, FLORIDA, SAME ALSO BEING THE SOUTHEAST BOUNDARY CORNER OF THAT CERTAIN
PROPERTY AS DESCRIBED IN OFFICIAL RECORDS BOOK 3219, PAGE 346 OF THE PUBLIC RECORDS OF PINELLAS
COUNTY, FLORIDA: THENCE LEAVING SAID SOUTH BOUNDARY LINE OF THE NORTHEAST 1/4 OF THE NORTHWEST 1/4
OF SECTION IS, N 00.00'08- W, AlONG THE EAST BOUNDARY LINE OF SAID WEST 1/2 OF THE NORTHEAST 1/4 OF
THE NORTHWEST 1/4 ~ SECTION 15, SAME ALSO BEING THE EAST BOUNDARY LINE OF SAID CERTAIN PROPERTY AS
DESCRIBED IN OFFICIAL RECORDS BOOK 3219, PAGE 346, SAME ALSO BEING THE EAST BOUNDARY LINE or SAID
CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL RECORDS BOOK 9956, PAGE 1415, FOR 52.68 FEET TO
THE NORTHERN MOST BOUNDARY CORNER or SAID CERTAIN PROPERTY AS DESCRIBED IN OFFICIAL RECORDS BOOK
3219, PAGE 346, SAME ALSO BEING THE POINT OF BEGINNING; THENCE CONTINUE N 00.00'08- W, ALONG SAID
EAST BOUNDARY LINE OF THE WEST 1/2 OF THE NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION IS, SAME
ALSO BEING SAID EAST BOUNDARY LINE OF THAT CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL
RECORDS BOOK 9956, PAGE 1415, FOR 111.84 FEET TO THE NORTHEAST BOUNDARY CORNER OF SAID CERtAIN
PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL RECORDS BOOK 9956, PAGE 1415. SAME ALSO BEING THE
SOUTHEAST BOUNDARY CORNER OF THAT CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK 915, PAGE 103 ~ THE
PUBLIC RECORDS ~ PINELLAS COUNTY, FLORIDA; THENCE LEAVING SAID EAST BOUNDARY LINE Of THE WEST 1/2
OF THE NORTHEAST 1/4 OF THE NORTK*'EST 1/4 OF SECTION 15, N 89.12'OS- W. ALONG THE NORTH BOUNDARY
LINE OF SAID CERTAIN PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 9956, PAGE 1415, SAME
ALSO BEING THE SOUTH BOUNDARY LINE Of SAID CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK 915, PAGE 103,
FOR 4.70 FEET to THE SOUTHWEST BOUNDARY CORNER OF SAID CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK
91~. PAGE 103: THENCE LEAVING SAID NORTH BOUNDARY LINE OF SAID CERTAIN PROPERTY DESCRIBED AS PARCEL
I I IN OFFICIAL RECORDS BOOK 9956, PAGE 1415, S 03.08'56- W, FOR 164.64 FEET TO THE NORTHEAST
BOUNDARY CORNER OF LOT I, REVISED MAP OF R.H. PADGETT'S SUBDIVISION, AS RECORDED IN PLAT BOOK 4,
PAGE 32 Of THE PUBLIC RECORDS OF PINELLAS COUNTY, FLORIDA, SAME ALSO BEING THE POINT Of INTERSECTION
WITH THE SOUTH BOUNDARY LINE OF SAID CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL RECORDS
BOOK 9956. PAGE 1415, SAME ALSO BEING ArORESAID SOUTH BOUNDARY LINE or THE NORTHEAST 1/4 OF THE
NORTHWEST 1/4 OF SECTION IS; THENCE S 89.IZ'05. E. ALONG SAID SOUTH BOUNDARY LINE OF THE NORTHEAST
1/4 OF THE NORTHW[ST 1/4 OF SECTION IS. SMfZ ALSO BEING SAID SOUTH BOUNDARY UNE OF SAID CERTAIN
PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 9956. PAGE 1415. FOR S,05 FEET TO THE
SOUTHWEST BOUNDARY CORNER OF AFORESAID CERTAIN PROPERTY AS DESCRIBED IN OfFICIAL REvORDS BOOK 3219.
PAGE 346: THENCE LEAVING SAID SOUTH BOUNDARY LINE OF THE NORTHEAST 1/4 OF THE NORTHWEST 1/4 or
SECTION 15. N 09-23'45- E. ALONG THE WEST BOUNDARY LINE OF SAID CERTAIN PROPERTY AS DESCRIBED IN
OFFICIAL RECORDS BOOK 3219, PAGE 346, FOR 53.Z7 FEET TO THE POINT OF BEGINNING AND CONTAINING 1,2B9
SOUARE FEET OR 0,0296 ACRES, MORE OR LESS.
I
CONDITIONS AND STIPULATIONS Continued
(continued and concluded from reverse side of Policy Face)
I
(0) The liability of the Company under this policy sholl 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 os
insured and the value of the insured estate or interest subject to the defect, lien
or encumbrance insured against by this policy,
(!1.) (This paroqraph removed in Florida policies, )
(c) The Company will pay only those costs, attorneys' fees and expenses
incurred in accordance with Section 4 of the Conditions and Stipulations,
8, APPORTIONMENT,
If the land described in Schedule A consists of !woor more parcels which ore
not used os 0 single site, and 0 loss is established affecting one or more of the
parcels but not 011, the loss sholl be computed and settled on 0 pro rota basis os
if the amount of insurance under this policy was divided pro rota os to the value
on Dote of Policy of each separate parcel to the whole, exclusive of any
improvements mode subsequent to Dote of Policy, unless 0 liability or value has
otherwise been agreed upon os to each parcel by the Company and the insured
at the time of the issuance of this policy and shown by on express statement or by
on endorsement attached to this policy,
9, LIMITATION OF LIABILITY,
(0) If the Company establishes the title, or removes the alleged defect, lien
or encumbrance, or cures the lock of 0 right of access to or from the land, or
cures the claim of unmarketability of title, 011 os insured, in 0 reasonably diligent
manner by any method, including litigation and the completion of any appeals
therefrom, it sholl hove fully performed its obligations with respect to that matter
and sholl 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 sholl hove no liability for loss or damage
until there has been 0 final determination by 0 court of competent jurisdiction,
and disposition of 011 appeals therefrom, adverse to the title os insured,
(c) The Company sholl 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 mode for costs. attorneys'
fees on expenses, sholl reduce the amount of the insurance pro tanto,
11, LIABILITY NONCUMULATIVE,
It is expressly understood that the amount of insurance under this policy
sholl be reduced by any amount the Compan)'-may pay under any policy insuring
o mortgage to which exception is token in Schedule B or to which the insured
has agreed, assumed, or token subject, or which is hereafter executed by on
insured and which is 0 chorge or lien on the estate or interest described or
referred to in Schedule A, and the amount so paid sholl be deemed 0 payment
under lhis policy to the insured owner,
12, PAYMENT OF LOSS,
(0) No payment sholl be mode 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 sholl 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
sholl be payable within 30 days thereafter,
13, SUBROGATION UPON PAYMENT OR SETTLEMENT,
(0) The Company's Right of Subrogation,
Whenever the Company sholl hove settled and paid 0 claim under this pol-
icy. 011 right of subrogation sholl vest in the Company unaffected by any oct of
the insured claimant,
The Company sholl be subrogated to and be entitled to 011 rights and reme-
dies which the insured claimant would hove hod against any person or property
in respect to the claim hod this policy not been issued, If requested by the Com-
pany. the insured claimant sholl transfer to the Company 011 rights and remedies
against any person or property necessary in order to perfect this right of subro-
gation, The insured claimant sholl permit the Company to sue. compromise or
settle in the nome of the insured claimant and to use the nome of the insured
claimant in any transaction or litigation involving these rights or remedies,
If 0 payment on account of 0 claim does not fully cover the loss of the
insured claimant, the Company sholl 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 oct of the insured claimant, os stated above,
that oct sholl not void this policy, but the Company, in that event, sholl be
required tOlay only that port of any losses insured against by this policy which
sholl 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 sholl exist
and sholl 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 low, arbitration pursuant to the Title Insur:
once 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 ore not limited to, any controversy or claim between the Company
and the insured arisinq out of or relatinq to this policy, any service of the
Company in connection with its issuance or the breach of 0 policy provision or
other obliqation, Arbitration pursuant to this policy and under the Rules in effect
on the dote the demand for arbitration is mode or, at the option of the insured,
the Rules in effect at Dote of Policy sholl be bindinq upon the parties, The award
may include attorneys' fees only if the lows of the state in which the land is
located permit 0 court to award attorneys' fees to 0 prevailinq party, Judqment
upon the award rendered by the Arbitrator!s) may be entered in any court
havinq iurisdiction thereof,
The low of the situs of the land sholl apply to on 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.
(0) This policy together with 011 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 sholl be construed os
o 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, sholl be restricted to this policy,
(c) No amendment of or endorsement to this policy con be mode except by
o writing endorsed hereon or attached hereto signed by either the President, 0
Vice President, the Secretory, on Assistant Secretory, 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 low, the policy sholl be deemed not to include that provision and 011
other provisions sholl 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 sholl be addressed to the Company ot P,O, Box 2029, Houston, T eXQS
77252.2029,
STE'VAl{T TI"I"LE
GUARANTY COMPANY
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-.--- fILE NUMBER: 7. lOMI NUlIiBER:
6.
990100B6
B. M1G. INS. CASE NO.:
C.NOTE: Thi' fo,m i, rumi'''''' m ,i" '0' , ,aw="' of ocm" "ttl"""m ro'"' Amo". V'id m ,... by ,h, ","-' ",.. '" ,howo, '1<'" m"''''
("p,u",") W", p,id oo"id' "" "..io,' ""y '" ,ho~ h," ru, i.fu""'du. "",.." ,... ,,,.,, i.dud'" ,. d" mal"~
D. NAME OF BORROWER: CllY Of CLEARWA1ER, fLORIDA,
ADDRESS: 1'.0. Boll. 474B, Clearwater, n 3375B-474B
E. NAME OF SELLER: GEORGE W. STONEY, lRUSTEE
ADDRESS: SELLER TIN:
F. NAME OF LENDER: CASH TRANSACTION
,
ADDRESS:
G.PROPERTY LOCATION: SECTION 15, TWSI' 29 S, RANGE 15 E
MADISON AVENUE
H. SETTLEMENT AGENT: STEWART liTLE Of CLEARWATER PHONE NUMBER: NOT ON fILE
ADDRESS: 1290 COURT ST.
CLEARWATER, fL 33756 SETTLEMENT AGENT TIN: 59-143391B
-
PLACE OF SETTLEMENT: SIEWART TITLE Of CLEARWA1ER I.SETTLEMENT DATE
ADDRESS: 1290 COURT ST. Closing date: 06/01/9'
CLEARWA1ER, fL 33756 Proration date: 06/01/9
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. Contract sales price 9,023.00 401. Contract sales price 9,023.(
102, Personal property 402, Personal property
103, Settlement charges to borrower(\ine 1400) 440.40 403,
104, 404,
-
105, 405,
Adjustments for items paid by seller in advance: Adjustments for items paid for seller in advance:
106, City/town taxes to 406, City/town taxes to
107, County taxes to 407, County taxes to
108, Assessments to 408, Assessments to
109, 409,
110, 410,
111. 411,
112, 412,
--
120, GROSS AMOUNT DUE FROM BORROWER: 9,463.40 420, GROSS AMOUNT DUE TO SELLER: 9,0;
200, AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500, REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deposit or earnest money 501. Excess deposit(see instrUctions)
202, Principal amount of new loan(s) 502, Settlement charges to se\ler(line 1400)
203, Existing !oan(s) taken subject to 503, Existing loan(s) taken subject to
204, 504, Payoff of first mortgage loan
205, 505, Payoff 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, City/town taxes to 510, City/town taxes to
211. County taxes to 511, County taxes to
212, Assessments to 512, Assessments to
213, 513,
214, 514,
215, 515,
216, 516,
217, 517,
218. 518,
219, 519,
220, TOTAL PAlO BY/FOR BORROWER: 520, TOTAL REDUCTION IN AMOUNT:
300, CASH AT SETTLEMENT FROM/TO BORROWER: 600, CASH AT SETTLEMENT TO/FROM SELLER:
301. GrosS amount due from borrower(line 120) 9,463.40 601. Gross amount due to seller(\ine 420)
302, Less amounts paid by/for borrower(line 220) 602, Less total reductions in amount due seller(line 520)
303, CASH IX FROMl I TOl BORROWER: 9,463.40 603, CASH IX TOl I FROMl SELLER:
SUBSTITUTE FORM \099 SELLER STATEMENT _ Th, i.fu""'"U" ro."i"'" i. BI"'" E,G,If ..d f ,... "" Ii", 40 \ (Of, if Ii'" 40\ i, ,,,,,i,,"', Ii"" 40'
" ,mport,.. '" i.fu"'" du. ,... i, ",i., rum i,"", m m' f.,,,,,,' ""."' S,Ni" , If ,00 '" "qui"" m m, , "",,", · ",Ii,,",, "..\~ Of "",,' "."iOf
h, impo'''' "" ,00 if mi, '10m ;, "q.i"" m h, "po"'" .... m, ,RS ",,""',"', m" it h.. ro' "". -"""
SELLER fNSTRUCTlON-1f m" ,,,I ,,,.,, w.. yuOf pri",ip'\ ".id''''', m, Fum> 2\ 19, S." Of E"h.." uf ",i.dp'\ """,,",,, ru, .., "iu, wim YUOf i
"mm; fOf um" _"dum, ,omp\'" m' ."lia'" p.-' uf Fom> 4197, Fom> 6252 ,""Of S,h""\' D (Fum> \040),
Y 00 ." "qui"" h, ,.. m ,ro,id' S"..rt Tid' uf O""w"'" fOO, wim yuOf ro"'" ",,,y" ,,,,.".adu' .um"'"
If yoo do 001 pro''''' S".." Tid, of CJ,,"''''' 1"" wim y"''' ro"'" ..p.y" id,""."dUU ",mh", 'u. m" oo ..hi'" ro d,if Of ,dmi"" ""'\"",
U..." "..It,,, uf ,,,ju", f ""if, m" "" oom"" ,hoW' UU mJ, ,"W",," I, my""'" ",p'y" ''''""It,,"UU uumOO'
1100, Tn
1101. Sett
1102, Ab~
1103, Titl~
1104, Title
1105, Docu
1106, Notar
107, Attor~
(ine
108, Title in.
(inel
l09, Lender'1
10, Owner's
11.
12, fl risk
13,
[4,
lO. GOVERm
11. Recording I
2 C'
, Ity/county
3, State .. /
...x stal
f. RECORD 2
),
"
I, ADDITIONAi
, Survey
, Pest inspection
TOTAL SETTLI
:ATJON' f h
I. I furth' aVe careful
fry Ihal f,
~rs C TY OF
',(.J//Y knowled <
...~., ge, the Hun
~:~,~
Jrt;D/OR PUR
~ ~ curren( ;~:S~ '.l,
oy com':1it"';~.' 10 IIs'b1'al:'
rfy esc(c tel accOlUlr n I
~~ the ~~~~ ~d ~
'r p~y has or ney and
.~ t<:~_lye fl"Qrn s~y.fihave.c
1M""'"
IrTfil.. r _ "6 )'car,
--
STEWART TITLE OF CLEARWATER, INC. (IIStewartll),
is providing title insurance and closing services, and has issued Commitment No. C - 99010086
dated February 23, 1999 5: 00 p. m . in connection with a real estate transaction in which you
are a party as a buyer, seller or mortgagor ("Transaction").
D1SCL\>smm, CONSENT AND GRANT OF PERI\kSION
TO EARN INTEREST ON ESCROWED FUNDS
Disclosure: Money owned by a party or partiea to your Transactioo will be received by Stewart in oonnection with the
Transaction and will be held by Stewart in Trost ("Escrowed Fonds") until disbnraement is properly anthorized, As a title
insurance agent licensed hy the Florida Deportment of )nsurllnce ("Deportment"), Stewart ia required by law and
Department rule to immediately depo5It Escrowed Funds, when received, in an escrow t_ account In a nnancial
institution insured by an agency of the federal government and located within this state.
Stewart intends, upon receiving all consents required in counection with the Transaction, to (a) deposit Escrowed Funds
from the Transaction, together with similar funds from other transactions, in an interest-bearing trust account, and (b)
retain the interest earnings from such trUSt accoont in consideration for services provided in administering and properly
disbursing the Escrowed Fnnds, Any escrow fee paid hy any party involved in this tr....ctlon shall ouly he for check
writing and computer Input, but not for any of the accounting, honkkeeping, auditing, messenger, and other servle..,
Department roles provide that a title agent may not deposit such funds in an interest-bearing unst account without the
written consent of the buyer and the seller in a sale transaction, or "use" money in its escrow trust accounts without
permission of the owner of the money, given after full disclosure of the ci~' Therefore. if this fonn (or a
counterpart hereof) is not signed (by both bnyer and seller if a sole transaction, or by the owner uf the Escrowed Funds
if a financing transaction) and received by Stewart prior to Stewart's receipt of the Escrowed Funds in its capacity as
escrow agent in the Transaction, the Escrowed Funds in this Transaction will be deposited in a trUSt account on whicb
no interest is earned.
Grant of Permission: Having read and understood the foregoing IIDisclosurell, I/we Purchaser/Borrower
o do, or 0 do not, and Seller 0 do, ur 0 do not herel>y grant permission for and consent to Stewart's deposit
of the Escrowed Funds in a trust account upon which interest will be paid to and retained by Stewart.
CITttOF CL~RWATER, FLORIDA,
Date
pri~~;--\:::)
As of
(Title) (Corporate or other entity name, if Applicable)
please check all that apply ~ Buyer / _Seller / _ Mortgagol
Date
Print Name:
As of
(Title) (Corporate or other entity name, if Applicable)
please check all that apply _ Buyer / _Seller / _ Mortgage
w,- I-q~
~~IG~~'
As of
(Title) (Corporate or other entity name, if Applicable)
please check all that apply _ Buyer / .-!.- Seller / _ Mortgal
TRUSTEE
Date
Date
Print Name:
As of
(Title) (Corporate or other entity name, if Applicable)
please check all that apply _ Buyer / _Seller / _ Mortga
i
SELLER'S AFFIDAVIT (GAP)
,
FILE NO: 99010086
ST ATE OF FLORIDA
COUNTY OF pinellas
BEFORE ME, the undersigned, this day personally appeared GEORGE W, STONE, TRUSTEE
(" Affiant(s)"), who, being by me first duly sworn, says:
1. GEORGE W. STONE, TRUSTEE
islare the owner(s) of certain real property located in pinellas County, Florida, which is
more particularly described on Exhibit "A" attached hereto and made a part hereof (the "Property"),
2, Affiant(s) is familiar with Stewart Title Guaranty Company's Owner's Title Insurance Commitment
No, C-99010086 bearing an effective date of February 23, 1999 5: 00 p. m,
(the "commitment").
3, There have been to my knowledge no documents recorded in the Public Records of P ine11 as
County, Florida subsequent to February 23, 1999 5: 00 p, m , which affect title to the Property
insured; and (i) that there are no mattets pending against them that could give rise to a lien that would
attach to the subject property between the effective date of the Commitment and the recording of the
instruments giving rise to the interest to be insured, and (ii) that the affiants have not executed aud will
not execute any instrument that would adversely affect the title to the subject property or the lieu of any
mortgage to be insured pursuant to the Commitment, save and except the following:
4, This affidavit is given to induce Stewart Title Guaranty Company and its authorized Agent,
STEWART TITLE OF CLEARWATER, INC, , to issue an Owner's Title Insurance Policy to
CITY OF CLEARWATER, FLORIDA,a Florida Municipal Corporation
Dated, this
day of
~qw1t.L/
,1999
_t.-e---
TRUSTEE
Sworn to and subscribed before me this
GEORGE W. STONE, TRUSTEE
J
day of
,~ Cft)ALL-
,19 99 ,by
islare personally known to me or who haslhave produced driver license(s) as identification,
,
My commission expo
~~..c;
.. ,.
~ n
DEBRA A. BORGH
Notary PubliC. S~,. 01 Florida
My (;ommiIeioII E";I" JII\, 30, 2001
Com/IllIeiOII' ceS,?"7
~~ ~~fv
Printed Name:
Notary Public
Serial Number
ORDER NO: 99010df6
1
D I S C LOS U R E
We, the owners/purchasers of that certain real property
located at: MADISON AVENUE,
pine11as 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 affect the value or
desirability of said property. except as set forth above, 1
acknowledge that this disclosure will be given to the listing
broker, the selling broker, and any prospective buyer.
CERTIFY that as the buyer{s) I have inspected the above
an accept same.
$~W~
GE R W. STONE, TRUSTEE
WITNESS
WITNESS
STATE OF FLORIDA
COUNTY OF pinellas
instrument was acknowledged before me this 17~ day
GEORGE W. STONE, TRUSTEE, who has produced
. as identific~ and who di! take an oath,
NOTJ~~I/ ) /Jth rf-
The foregoing
of~, 1999, by
~ t.vl--ll-
My Commission Expires:
DEBRA A, BORGH
PubliC 5\1\8 01 florlda
No\a", , siOIl (apil" Jan. 30, 'lOO'
lAy ~i'siOfI' cc~tl~'
-.--
STATE OF FLORIDA
COUNTY OF pinellas
f~(,
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The foregoing
of May, 1999,
produced
an oath.
instrument was acknowledged before me this 24th day
by . as of. who ha'
, as identification and who did take
NOTARY PUBLIC
My commission Expires:
-
\
,
ORDER NO:
NON-FOREIGN CERl'IFICATION BY INDIVIDUAL TRANSFEROR
--------------------------------------------------
1. section 1445 of the Internal Revenue code provides that a
transferee of a United states real property interest must
withhold tax if the transferor is a foreign person.
2. In order to inform the transferee that withholding of tax is not
required upon the disposition by
GEORGE W. STONE, TRUSTEE of the United states real
property described as followS:
SEE EXHIBIT A
the undersigned transferor certlfles and declares by means of
thls certifical:ion, the following:
(a) I (We) am (are) not non-resident alien(s) [or purposes of United
states income taxatlons and,
(b) 11y United States taxpayer identifylng number(s} (social security)
is ( are) :
NAME SOCIAL SECURITY NUMBER
GEORGE w. STONE, #
TRUSTEE I
(c)
(d)
My home address is
(attached additional page if necessary)
'l'here are no other persons who have an ownership interest in the
above-described property other than those persons set forth above
in subparagraph (b).
J .
'l'he undersigned hereby further certif ies and declares:
(a)
I (We) understand that the purchaser of the above described proper'
intends to rely on the foreg01ng representations in connection
with the unJted states Foreign Investment in Real property Act.
(94 statute 26112 as amended).
I (we) understand this certification may be disclosed to the Inter
llevenue Service by transferee and that any false statement contain
in this certification may be punished by rine, imprisonment or bot
(lJ)
Under penalties of perjury I (we) declare I (we) have examined carefull
this certification and it is true, correct and complete.
~~
('l'his document must be retaineu until the end or the fifth taxable
year following the taxable year in which the transfer takes place).
CONSUll'l' YOUR l\'l"l'Oll.NEY MID/OR 'l'AX ADVISOR - NO REPRESENTA'rION all.
RECOMMENDATION IS MADE BY S'l'l~\'1AR'l' 'l'I'l'l~E INSURANCE COMPANY AND/on
.-STJiUART TTl1 F. GIJARANIY-~ANY ___ CONCEmUNG 'l'IIE LEGAL
SUFFICIENCY AND/OR 'l'l\X CONSEQUENCES OF TillS DOCUMEN'l'. YOU MAY BE
REQUIRED '1'0 FILE A COpy OF 'rillS DOCUMEN'!' WI'l'1l TilE IN1'ERNAL REVENUE
SERVICE. 'l'IlESE AilE QUESTIONS FOR YOUH A'!'1'OHNEY OR 'i'AX ADVISOIl..
S'!'ATE OF FLORIDA
COUNTY 0 F .PINELlAS
'The foreqoing instrument was acknowledged
1999 by GEORGE W. STONE, TRUSrEE
. who has produced
WllO did take an oath.
,-]
'before me this )44- day of-l
as identification and
My commission Expires:
~~ Q,6hl---
t 'l\RY PUBLIC'
~~"Go
"" ~
o -
It n
DEBR1. 1.. BORGH
Not.1V Public. Sl.l. 01 Florida
l.Iy Commission bp'..IIn. 30, 2001
CommiSsion' CCSI1S17
-
", .'
\
I
AUTHORIZATION AND ACKNOWLEDGEMENT FORM
DATE:
FILE NO.: 99010086
LEGAL:
SEE EXHIBIT A
SELLER:
GEORGE W. STONE, TRUSTEE
BUYER:
CITY OF CLEARWATER, FLORIDA, a Florida Municipal
Corporation
We hereby approve and acknowledge receipt of a copy of the
Statement and actual cost (DISCLOSURE/SETTLEMENT STATEMENT - HUD
FORM 1) and authorized disbursement of funds as shown therein this
day of. 19. 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,
1nc,. cannot. at this time, ascertain 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 of Clearwater,
Inc. Stewart Title of Clearwater will not be held responsible,
THAT ALL UTILITY BILLS (WATER, SEWER, ELECTRIC, MAINTENANCE
FEES) HAVE BEEN PAID OR WILL BE PAID UPON RECEIPT OF FINAL BILLS,
~INITIALS INITIALS INITIALS INITIALS
SELLER'S BUYER'S
CITY OF CLEARWATER, FLORIDA,
~~~~;EE
SELLER'S FORWARDING ADDRESS:
f o. fY.>>- j784l0
lQJ~l'llJ )()~ I r ~ ?;)../~lL-
HOME PHONE#
BUYER'S FORWARDING ADDRESS:
HOME PHONE#
WORK PHONE#
WORK PHONE#
THIS IS TO FURTHER AUTHORIZE TO
APPROVE ANY CHANGES NECESSARY TO THE CLOSING STATEMENT.
STEWART TITLE OF CLEARWATER, INC.
BY:
-
?"
" .
_ This Instrument Prepared by and Retur1to:
MARIANNE SCHAFFER
of srEWARTTITLEOFCLEARWATER, INC.
1290 Court Street
Clearwater, Florida 33756
,
as a necessary incident to the fulfillment of conditions
contained in a title insurance commitment issued by it.
Property Appraisers Parcel Identification (Folio) Number(s):
15_29-15-00000-210-0700
TRUSTEE AFFIDAVIT
FILE NO: 99010086
STATE OF Florida
COUNTY OF citrus
Before me, the undersigned. authority. duly commissioned by the laws of Florida. on the ;;l 'ir-!- ~
day of April ,19 99, personlly appeared SUNTRUST BANK, Nature Coast,
by:
who having been first duly sworn deposes and says:
/Successor
1. Affiant is the Trustee of the Mad tal Trust as established by Article VI of the
Last Will and Testament of Ira A. Desper, dated March 9, 1989
as evidenced by ~XX8i the Trust ~.
2. The following property is included in the Trust:
See Attached Schedule "An
3. Affiant has full power and authority to sell and or mortgage the above described property
as evidenced by ItiWtxxxxx~the Trust {aUoohe14) and no contrary powers or restrictions
appear in the trust document.
4. The Trust is in full force and effect and has been during the period of ownership of the
above described property.
THIS AFFIDAVIT IS MADE WITH THE FULL KNOWLEDGE THAT STEWART TITLE OF
CLEARWATER, INC. WILL RELY ON THE TRUTH OF THE
STATEMENTS MADE IN THIS AFFIDAVIT TO INDUCE SAID COMPANY TO ISSUE
A POllCY OF TITLE INSURANCE.
April
19 99, by
Sworn to and subscribed before me this ZS -II- day of
SUNTRUST BANK, Nature CoastJ----
who is personally known to me or who has produced driver license(s) as identification.
My Commission expires:
#,,,.. r~ Craig H COppedge
*1 *My CommIssIOn CC73&879
'''''~ Explres April 28. 2002
-:.',.
GAL Dt-SCRIPTlON: I 1
:.:.. ;'AACEl Of LAND BE ING A POR~ON ~ THAT CERTAIN PROPERTY DESCRIB~D AS PARCEL I I IN OFF ICIAl RECORDS
BOOK 9956. PAGE 141S ~ THE PUBLIC RECORDS or PINELLAS COUNTY. FLORIDA. LYING WITHI" THE WEST I/Z Of
THE NORTHEAST 1/4 OF THE NORTHWEST 1/4 OF SECTION 15. TOWNSHIP Z9 SOUTH. RANGE 15 EAST. CITY Of
.CLEARWATER. PINElLAS COUNTY. FLORIDA. BEING t.t)RE PARTICULARLY DESCRIBED AS FOllOWS:
C~NCE AT THE SOUTtfNEST CORNER ~ THE NORTHEAST 1/4 Of THE NORTK*'EST 1/4 Of SECTION 15. TClNNSHIP
29 SOUTH. RANGE 15 EAST. CITY OF CLEARWATER. PINELLAS COUNTY. FLORIDA; THENCE S 89.12'05' E. ALONG
THE SOUTH BOUNDARY LINE Of SAID NORTHEAST 1/4 OF THE NORTHWEST 1/4 Of SECTION 15 (BEING THE 8ASIS OF
BEARINGS FOR THIS DESCRIPTION). fOR 665.46 FEET TO THE SOUTHEAST CORNER Of THE WEST IIZ Of SAID
NORTHEAST 1/4 Of THE NORTHWEST II" OF SECTION 15. SAK ALSO 8EINO THE SOUTHEAST BOUNDARY CORNER OF
THAT CERTAIN PROPERlY DESCRIBED AS PARCEL I I IN OfFICIAL RECORDS BOOK 9956. PAGE 1"15 OF Ttf: PUBLIC
RECORDS Of PINELl.AS COUNTY. FLORIDA. SM€ ALSO BEING THE SOUTHEAST BOUNDARY CORNER OF THAT CERTAIN
PROPERTY AS DESCRIBED IN OfFICIAL RECORDS BOOK 3219. PAGE 346 Of THE PUBLIC RECORDS OF PINELLAS
COUNTY. fLORIDA; THENCE lEAVING SAID SOUTH BOUNDARY LINE Of THE NORTHEAST II" Of THE HORTtMST 1/4
f:F SECT ION 15. N 00.00' 08' ". ALONG THE EAST BOUNDARY LI NE Of SA I D WEST 1/2 Of THE NORTHEAST I I" OF
THE NORTHWEST 1/4 OF SECTION 15. SAME ALSO BEING THE EAST BOUNDARY lINE OF' SAID CERlll" PROPERTY AS
DESCRIBED IN OFFICIAL RECORDS BOOK 3219. PAGE 3<46. SAME ALSO BEING THE EAST BOUNDARY LINE OF SAID
CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OfFICIAL RECORDS BOOK 9956. PAGE 1"15. fOR 5Z.68 FEET TO
THE NORTHERN MOST BOUNDARY CORNER Of SAID CERTAIN PROPERTY AS DESCRIBED IN OFf ICIAl RECORDS BOOK
3219. P.GE 346, S~ ALSO BEING THE POINT OF BEGINNING; THENCE CONTINUE N 00.00'08. W. ALONG SAID
EAST BOIJNDARY l I t€ Of THE WEST '/2 Of THE NORTHEAST 1/4 OF THE NORTHWEST 114 Of SECT I ON 15. S~
ALSO BEING SAID EAST BOUNDARY LINE Of THAT CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL
RECORDS BOOK 9956. PAGE 1415. FOR 111.84 FEET TO THE NORTHEAST BOUNDARY CORNER OF SAID CERlAIN
PROPERTY DESCRIBED AS PARcEL I I IN OFFICIAL RECORDS BOOK 9956. PAGE 1415. SAME ALSO BEING THE
SOUTHEAST BOUNDARY CORNER or THAT CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK 915. PAGE 103 OF THE
P\J9L1C RECORDS OF PINEl~ COUNTY. FLORIDA: THENCE lEAVING SAID EAST BOUNDARY LINE or THE WEST III
OF -mE NORTHEAST 114 Of nE: NORTKfr'EST 1/4 Of SECT! OH 15. N 89. 12.'05' ... ALONG THE NORTH BOUNDARY
LINE OF SAID CERTAIN PRoPERTY DESCRIBED AS PARCEL II IN OfFICIAL RECORDS BOOK 9956. PAGE 1"15. S~
ALSO BEING THE SOUTH BOUNDARY LINE OF SAID CERTAIN PROPERTY AS DESCRIBED IN DEED 800K '15. PAGE 103.
FOR 4.70 FEET TO THE SOUTHW(ST BOUNDARY CORNER Of SAID CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK
91~. PAGE 103: THENCE LEAVING SAID NORTH BOUNDARY LINE Of SAID CERTAIN PROPERTY DESCRIBED AS PARCEL
I I IN OfFICIAL RECORDS BOOK 9956. PAGE 1415. S 03-08'5" W. FOR 164.64 FEET TO THE NORTHEAST
BOLWARY CORNER or lOT'. REVISED MAP OF R.H. PADGETT'S SUBDIVISION. AS RECORDED IN PLAT BOOK 4.
PAGE 32 Of THE PU8L1 C RE CORDS or , I NElLAS COUNTY, fLOR I DA. SME: ALSO BE I NG THE PO I NT Of I NTERSECTI ON
WITH THE SOUTH BOUNDARY LINE Of SAID CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OfFICIAL RECORDS
BOOK 9956. PAGE 1415. S~ ALSO BEING AFORESAID SOUTH BOUNDARY LINE Of THE NORTHEAST 1/4 Of THE
NORTHWEST 1/4 or SECTION 15: THENCE S 89.12'05" E. ALONG SAID SOUTH BOUNDARY LINE or THE NORTHEAST
1/4 OF THE NORTHWEST 1/4 or SECTION 15. SAM( ALSO BEING SAID SOUTH BOUNDARY LINE OF SAID CERTAIN
PRoPERlY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 9956. PAGE 1415. FOR 5.05 fEET TO THE
SOUTHWEST BOUNDARY CORNER Of AFORESAID CERTAIN PROPERTY AS DESCRIBED IN OFFICIAL RE~ORDS BOOK 3219.
PAGE 346: THENCE lEAVING SAID SOU1H BOUNDARY LINE Of THE NORTHEAST 1/4 or THE NORTHWEST 1/4 or
SECTION 15. N 09.23'45' E. ALONG THE WEST BOUNDARY lINE OF SAID CERTAIN PROPERTY AS DESCRIBED IN
OFFICIAL RECORDS BOOK 3219. PAGE 346. FOR 53.27 FEET TO THE POINT Of BEGINNING AND CONTAINING 1.2e~
SQUARE FEET OR O,OZ96 ACRES. MORE OR LESS.
l)lis Instrument Prepared by and Return to:
MARIANNE SCHAFFER I
<Ji STEWART TITLE OF CLEARWAn!t, INC.
1290 Court Street
Clearwater, Florida 33756
,
as a necessary incident to the fulfillment of conditions
contained in a title insurance commitment issued by it.
Property Appraisers Parcel Identification (Folio) Number(s):
15_29_15-00000-210-0700
TRUSTEE AFFIDA VIT
FILE NO: 99010086
STATE OF Florida
COUNTY OF pinellas
Before me, the undersigned, authority, duly commissioned by the laws of Florida, on the J sJ-'
day of ~ 19 99, personlly appeared GEORGE W. STONE
~
who having been first duly sworn deposes and says:
1. Affiant is the Trustee of the J. O. STONE GRANDCHILDREN'S TRUST
as evidenced by~Kg~xxxx~}{he Trust (}(K2{~.
2. The following property is included in the Trust:
See Attached Schedule nAil
3. Affiant has full power and authority to sell and or mortgage the above described property
as evidenced byct'KgPXxx~the Trust tat~" and no contrary powers or restrictions
appear in the trust document.
4. The Trust is in full force and effect and has been during the period of ownership of the
above described property.
THIS AFFIDAVIT IS MADE WITH THE FULL KNOWLEDGE THAT STEWART TITLE OF
CLEARWATER, INC. WILL RELY ON THE TRUTH OF THE
STATEMENTS MADE IN THIS AFFIDAVIT TO INDUCE SAID COMPANY TO ISSUE
A POLICY OF TITLE INSURANCE.
~~~~
EO GE . STO E
Sworn to and subscribed before me this J~ day of UAA'\.-l- 19 99 ,by
GEORGE W. STONE U - - -
who is personally known to me or who has produced driver license(s) as identification.
My Commission expires:
j)(LL~cc (ft /<M~
Pnnted Name:
Notary Public
Serial Number
--.....
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DEBRA A. BORO~\
public: Slale 01 Fl1;,lt
~~mlatloll f..pi'" J.... ~, ,',c
Y commls1iOn , CC~91~~'
--"'-"'-~'
\
...
)
I
I
LlGAL D~SCRIPTIOH:
A PARCEL Of LAND BEING A PORTION Of THAT CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OfFICIAL RECORDS
BOOK 9956, PAGE 1415 OF THE PUBLIC RECORDS OF PINELLAS COUNTY, FLORIDA, LYING WITHIN THE WEST 1/2 OF
o THE NORTHEAST 1/4 c:E THE NORTtM(ST 1/" OF SECTION I~, TOWNSHIP 29 SOUTH. RANGE I~ EAST. CITY OF
CL~AlER, PINELLAS COUNTY. FLORIDA. BEING MORE PARTICULARLY DESCRIBED AS FOllOWS:
Co.t.ENCE AT THE SOUTtMST CORNER Of THE NORTHEAST 1/4 OF THE NORTK-NEST 1/" OF SECT ION 15, TOHNSHIP
29 SOUTH, RANGE 15 EAST. CITY OF CLEARWATER, PINELLAS COUNTY, FLORIDA; THENCE S 89.12'05' E, ALONG
THE SOUTH BOUNDARY LINE OF SAID NORTHEAST 1/4 Of THE NORTHWEST 1/4 OF SECTION 15 (BEING THE BASIS OF
BEARINGS FOR THIS DESCRIPTION), FOR 665.46 FEET TO THE SOUTHEAST CORNER Of THE WEST 1/2 OF $AID
NORTHEAST 1/4 Of THE NORTH'fIt:ST 1/4 Of SECTION I~, SME: ALSO BEING THE SOUTHEAST BOUNDARY CORNER OF
THAT CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL RECORDS BOOK 99~, PAGE 1"15 OF THE PUBLIC
RECORDS or PINELLAS COUNTY, FLORIDA, SAME ALSO BEING THE SOUTHEAST BOUNDARY CORNER OF THAT CERTAIN
PROPERTY AS DESCRIBED IN OfFICIAL RECORDS BOOK 3219, PAGE 346 OF THE PUBLIC RECORDS OF PINELLAS
COUNTY, FLORIDA: THENCE LEAVING SAID SOUTH BOUNDARY LINE OF THE NORTHEAST 1/4 OF THE NORTHWEST 1/4
Of" SECT I ON 15, N 00.00' 08" W, AlONG THE EAST BOUNDARY LINE OF. SA I D WEST 1/2 OF THE NORTHEAST 1/4 OF
THE NORTHWEST 1/4 or SECTION I~, SAME ALSO BEING THE EAST BOUNDARY LINE Of SAID CERTAIN PROPERTY AS
DESCRIBED IN OFFICIAL RECORDS BOOK 3219, PAGE 346, SAME ALSO BEING THE EAST BOUNDARY LINE OF SAID
CERTAIN PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 99~6, PAGE I"I~, FOR 52.68 FEEl TO
THE NORTHERN MOST BOUNDARY CORNER OF SAID CERTAIN PROPERTY AS DESCRIBED IN OfFICIAL RECORDS BOOK
3219, PAGE 346, SAME ALSO BEING THE POINT or BEGINNING: THENCE CONTINUE N 00.00'08" W, ALONG SAID
[AST BOUNDARY LINE Of THE WEST 1/2 OF THE NORTHEAST 1/4 OF THE NORltflfEST 1/4 OF SECTION 15, SW€
ALSO BEING SAID EAST BOUNDARY LINE OF THAT CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OFFICIAL
RECORDS BOOK 9956, PAGE 1~15, FOR 111.8" fEET TO THE NORTHEAST BOUNDARY CORNER OF SAID CER1AIN
PROPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 9956, PAGE 1415, SAME ALSO BEING THE
SOUTHEAST BOUNDARY CORNER OF THAT CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK 91~, PAGE 103 Of THE
PUBLIC RECORDS or PINELLAS COUNTY, FLORIDA; THENCE LEAVING SAID EAST BOUNDARY LINE OF THE WEST I/Z
OF THE NORTHEAST 1/4 OF Ta: NORTKttST 1/4 OF SECTION IS, N 89.12'05" W, ALONG THE NORTH BOUNDARY
LINE OF SAID CERTAIN PRoPERTY DESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 9956, PAGE 1415, SAME
ALSO BEING THE SOUTH BOUNDARY LINE OF SAID CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK 915, PAGE 103,
FOR ~.70 FEET 10 THE SOUTHW[ST BOUNDARY CORNER OF SAID CERTAIN PROPERTY AS DESCRIBED IN DEED BOOK
91~, PAGE 103: THENCE LEAVING SAID NORTH BOUNDARY LINE Of SAID CERTAIN PROPERTY DESCRIBED AS PARCEL
I I IN OFFICIAL RECORDS BOOK 9956, PAGE I"I~, S 03.08'560., FOR 164.6" FEET TO THE NORTHEAST
BOUNDARY CORNER or LOT I, REVISED MAP OF R.H. PADGETT'S SUBDIVISION. AS RECORDED IN PLAT BOOK 4.
PAGE 32 OF THE PUBLIC RECORDS OF PlNELLAS COUNTY, FLORIDA, SMt: ALSO BEING THE POINT OF INTERSECTION
WITH THE SOUTH BOUNDARY LINE or SAID CERTAIN PROPERTY DESCRIBED AS PARCEL II IN OfFICIAL RECORDS
BOOK 9956, PAGE 1415, SAME ALSO BEING AFORESAID SOUTH BOUNDARY LINE or THE NORTHEAST 1/4 or THE
NORTHWEST 1/4 Of SECTION I~: THENCE S 89.IZ'05" E. ALONG SAID SOUTH BOUNDARY liNE Of THE NORTHEAST
1/4 OF THE NORTHWEST 1/4 or SECTION IS, SAME ALSO BEING SAID SOUTH BOUNDARY LINE OF SAID CERTAIN
PROPERTY OESCRIBED AS PARCEL I I IN OFFICIAL RECORDS BOOK 9956, PAGE 1"15. fOR 5.05 FEET TO THE
SOUTHWEST BOUNDARY CORNER Of AFORESAID CERTAIN PROPERTY AS DESCRIBED IN OFFICIAL RE~ORDS BOOK 3219.
PAGE 346: THENCE LEAVING SAID SOUTH BOUNDARY LINE OF THE NORTHEAST II" Of THE HQRTHWtST 1/4 or
SECTION 15. N 09"23'45" E. ALONG THE WEST BOUNDARY LINE OF SAID CERTAIN PROPERTY AS DESCRIBED IN
OFFICIAL RECORDS BOOK 3219. PAGE 346, ~OR 53.27 FEET TO THE POINT or BEGINNING AND CONTAINING 1,289
SQUARE FEET OR 0.0296 ACRES. MORE OR LESS.
I J
.' I
INFORMATION FOR REAL ESTATE 1099 REPORT FILING
as Required by the Internal Revenue Service
Section 6045 of the Internal Revenue Code, as amended by the Tax Reform Act of 1986, requires the reporting of
certain information to the IRS on real estate transactions. From the information you provide below, a Form 1099-S
will be produced and a copy of it will be furnished to the I.R.S. 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 NO:
99010086
TAXPAYER I.D. #
SELLER NAME:
GEORGE W. STONE, TRUSTEE
Other (Name of Entity):
MAILING ADDRESS
Street: f o. ,0"-;i-....
City: C:GEtVt /.U ft\€ 12
(,,8LV b
~
State:
Zip Code:
J Y ltJ~ -z,-
TRANSACTION INFORMATION
Closing Date:
Description of Property:
MADISON AVENUE
Contract Sales Price:
$9,023.00
Hud Line 406
Hud Line 407
Total Seller Tax Credit - $
0.00
If multiple Sellers - Request is hereby made that you allocate the sales price among the sellers as follows:
Has the seller received (or will receive) property (other than cash and consideration treated as cash) or services as
part of the consideration for this transaction? (YES or NO)
CERTIFICATION
Under penalties of perjury, I certify that the number shown on this form is my correct Taxpayer Identification Number.
I also certify that the other information shown herein is correct. I ACKNOWLEDGE RECEIPT OF A COpy OF THIS
FORM.
DATE:
G ) ) )qq
sel~~~
SETfLEMENT AGENT INFORMATION
STEWART TITLE OF CLEARWATER, INC.
1290 Court Street
Clearwater, Florida 33756
(727)441-2689
Taxpayer J.D. Number
59-1433918
SUBSTITUTE FORM 1099
This 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 to be reported and the
IRS determines that it has not been reported.
-................................................ --...-..................... ---- -----...-............ -- --.................................... ----... ----- ----............
(Completion of this form checked by
TO.DE FILLED IN PERSONALL i
BY SEL.LER on haRRoWER IN HIS OWN I-tANDWRITING
INDEMNITY ANO AFFIDAVIT AS TO UEDTS, l.IENS, ANll POSSESSION
USE SEPAnATE FonM Fon EACII.!~!rry~ .~.....,.. .,.,
GFDRGE W. STONE , lRUSTEE
SEE EXHIBIT ,A
Seller or Owner.Dorrower
Conlrlclor (If new con.lrncllon)
,I
I'urcha .er
peuonally "nown 10 me 10 be Ihe petlon w,ho.e namc I. .ub.crlbed herelo, Ind upon 111. ollh depo.e. and 'IY':
I, Ihe seller. owner-borrower, and/or conlraclor, repre.enl 10 Ihe fJurchl.er Indlor lender In Ihll Irlnllcllon
Ih,1 10 my knowledgc Iherc are: J' '
I. No ullpald debl. for plumblns flxlures. Wiler hellefl. noor furnace., Ilr condlllonetl. rldlo or lelevlslon an-
ICllnAe. carpellnB. russ, lawn sl,rln"lInl IYllems, venellan blinds. wludow .hadee, dnperlea, electric Ip(1\1I11CCl.
fCllcu. sheel 1llVlng. or any Ilenonalllfoperly or rlltluru Ihal ore lOCI led on Ihe .ubJecl properly de.crlbed
a hove. and Ihal no such Ilems hRYe been purchased on lime I,aymenl contracls. and Ihcre are no lecurily
IlIlerul.!l on .uch properly lecured by I flnlnclns .Ialemenl, lecmlly Isreemenl or olherwlse excepl Ihe
followlns: (ar none, 10 .Iale.)
NAME ANI) ADDItESS OF SECURED PARTY Approdmlle Amounl
.
1. No loarll of any kind on IIld properly excepl Ihe followlns: (U none, .0 "ale,)
NAME AND ADDRESS OF CREDITOR Approdmlle Amounl
3. Alllnbor and malerlal used In Ihe conslrucllon of Improvemenls or repal,. on Ihe above described properly
hRYe been paid for and Ihere Ire now no unpaid labor or malerlal claims a.alnll Ihe Imllfovemenl. or Ihe
pruperly upon which !Rme are situaled. and I hereby declare Ihal all lum. of money due for Ihe erecllon of
Improvemenls or re"alrs have been fully paid and salisfied. ucep!: (If 1I0ne, .0 .Iale.)
NAME ANI> AUUHESS OF SUPPLIER OF LADUnl SERVICES OR MA TEIlIAI.S Approximate Arnounl
"
4. I, Ihe IJUrchuer, represenl Ihal I have no knowledge of any debls or lien. of any kind olher Ihan Ihole Iilled
above, excel'l: (If none, so IIAlc.)
NAME AND ADDRESS UF SECURED rAinY, CIlEUITUR1 surl'UER OF
LABon OR MA l'ERIALS Approxlmale Amoun'
~. I. lhe owner-borrower, or I'urchaserl have nol been liven nollce of Ihe rurnlshin. or Inlenl 10 furnish any labor.
.ervices, or malerlals In connecllon whh Iny Improvemenl' or repairs 10 nld properly from any penon or nrnu,
, excelll: (If none, 10 III Ie.)
SUI'PUER OR "ADOn, SEItVICES un MATERIALS AUDRESS
6. I, Ihe nnderslgned owner, funher cer!lry Ihp,tlhe real eslale and personal "roperly above described are ill the
aclual posse.ssiun or lhe undersigned and Is nolln Ihe possession, aclual ur conslruclive, or Iny person, person"
or orBanizalions huldlng or claiming .Ime, adversely 10 Ihe undersigned under contracl. lease, or any olher cotor
uf lille or rlghl ur possession.
lhe Irnprovemenl. or repalu 10 laid properly are now compleled and have been Iccel,led by purchaler and/or
owner-borrower.
INDEMNITY: I, TilE. SELLER, OWNER-nORROWER, AND/OR CONTRACTOR. AGREE TO I'A Y ON I1EMAND
TO Till! I'UIlCIIASEltS ANn/Oil U!NDEllIN TillS TitANS ACTION. THEm SUCCl!SSOItS ANll ASSIGNS, ALL
AMOUNTS SEC\lItED IIY ANY ANI> AU. 1.I1!NS NOT SHOWN AIlOV!!, TOOETllmt WITII ALl, COSTS, LOSS
Ar~D ATHJRNEV'S FEES THAT SAIl> l'AllTIl!S MA Y INCUIt IN CONNECTION WITII SUCII UNMENllqNEO
LIENS. I'IH.lVII>EI> SAIl> LIENS l!ITIIHlt CtJRRI!NTI.Y API'L Y TO SUUJ(!CT I'ItOI'l!ItTY, OR A l'Aln TIIEIU!-
(W, Oil AItE SlJUSEQUENTLY ESTAIH.lSIIl!D AGAINST SAID PROPEIlTY ANI> ARI! CIU!ATEIJ BY ME,
KNOWN TO ME OllilA VE AN INCEPTION UATI! PRIOR TO Till! coNSUMMATION OF TillS TRANSACTION.
I realize Ihal Ihe Ilurchaser and/or lender In Ihl. Irlnsacllon arc relylnl on Ihe representallon conlalned herein III purchasing
lime or lendlns money Ihereon Ind would nol purchase lame or lend money Ihereon unlelS uld rcpresenlallons were made.
2:s;'l'l: Q~~
. STONE lRUSTEE
SWORN TO AND SUDSCRIDED Dl!rORI! MI! TIIIS~dayof
~6L UA5CHP'
Nolary Public In ami for ~T"~T' ,~ Counly,
~Cfu.'M-
, 19 99
My Com
..........,. nnTT"."
EXHIBIT 1
I
~
CERTIFICATION FOR NO INFORMATION REPORTING
ON THE SALE OR EXCHANGE OF A PRINCIPAL RESIDENCE
This form may be completed by the seller of a principal residence. This information is necessary
to deternline whether the sale or exchange should be reported to the seller, and to the Internal
Revenue Service on Form 1099-S, Proceeds From Real Estate Transactions. If the seller
properly completes Parts I and Part III, and makes a "yes" response to assurances (I) through (4)
in Part II, no information reporting to the seller or to the Service will be required for that seller.
The term "seller" includes each owner ofthe residence that is sold or exchanged. Thus. if a
residence has more than one owner, a real estate reporting person must either obtain a
certification from each owner (whether married or not) or file an information return and furnish a
payee statement for any owner that does not make,the certification.
Part I.
Seller Information
1.
Name
GEORGE W. S'IONE, TRUSTEE
2. Address or legal description (including city, state, and ZIP code) of residence being sold
or exchanged.
SEE EXHIBIT A
3. Taxpayer Identification Number (TIN)
Part II.
Seller Assurances
Check "yes" or "no" for assurances (1) through (4)
Yes No
(I) I owned and used the residence as my princi pal residence for
periods aggregating 2 years or more during the 5-year period
ending on the date of the sale or exchange of the residence.
(2) I have not sold or exchanged another principal residence
during the 2-year period ending on the date of the sale or
exchange of the residence (not taking into account any sale or
exchange before May 71 1997).
(3) No portion oCthe residence has been used for business or
rental purposes by' me (or my spouse ifl am married) after May
6, 1997.
(4) At least one o( the following three statements applies:
The sale or exchange is of the entire residence for $250,000 or
less.
OR
I am married, the sale or exchange is of the entire residence for
$500,000 or less, and the gain on the sale or exchange of the
entire residence is $250,000 or less.
QR
I am married, the sale or exchange is of the entire residence for
1500,000 or less, and (a) I intend to file a joint return for the
year of the sale or exchange, (b) my spouse also used the
residence as his or her principal residence for periods
aggregating 2 years or more during the 5 year period ending on
the date of the sale or exchange of the residence, and (c) my
spouse also has not sold or exchanged another principal
residence during the 2-year period ending on the, date of the sale
or exchange of the residence (not taking into account any sale
or exchange before May 7, 1997).
Part III.
Seller Certification
Under penalties of perjury. I certify that all the above information is true as the end of
the da of the sale 0 xchange.
::c;::;:>
(g~ jq I
Date