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Home My WebLink AboutL 13165 P 544 11111111 IIII IIIA VIII VIII 11111(IIII VIII VIII IIII 1111 I l l i l l l l l i l l l l l l l l l l l l l l l SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 07/20/2022 Number of Pages : 8 At: 12 :22 :56 PM Receipt Number : 22-0117465 TRANSFER TAX NUMBER: 21-42037 LIBER: D00013165 PAGE : 544 District: Section: Block: Lot: 1000 035 . 00 01 . 00 027 . 002 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $1,300 ,000 .00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $40 . 00 NO Handling $20 .00 NO COE $5 .00 NO NYS SRCHG $15 . 00 NO EA-CTY $5.00 NO EA-STATE $125 . 00 NO TP-584 $5 .00 NO Notation $0 . 00 NO Cert.Copies $0 .00 NO RPT $200 . 00 NO Transfer tax $0 .00 NO Comm.Pres $23, 000 . 00 NO Fees Paid $23,415 . 00 TRANSFER TAX NUMBER: 21-42037 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County ❑1 RECORDED 2022 Jul 20 12:22:56 PM JUDITH R. PPSCPLE Number of pages CLERK OF SUFFOLK COUNTY L D00013165 This document will be public P 544 record.Please remove all DT# 21-42037 Social Security Numbers prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 FEES .Page/Filing Fee 10 - Mortgage Amt. 1.Basic Tax Handling 20, 00 2. Additional Tax TP-584 _ Sub Total 5pec✓Assit. Notation �• or Fro-5217(County) Sub Total Spec./Add. EA-5217(State) R.P.T,S.A. _ V TOT.MTG.TAX 0 `1 Dual Town Dual County nn� Held for Appointme t Comm.of Ed. 5, 00 1" Transfer Tax Affidavit �+ Mansion Tax The property cove ed bythis mortgage is Certified Copy or will be improved by a one or two NYS Surcharge 15. 00 family dwelling only. Sub Total YES or NO Other _ Grand Total If NO, see appropriate tax cla se on page# ' of this I stri nt. 4 D€st. 220283541000 03500 0100 027002 7- 5 Community Preservation Fund Real Propert [ Consideration Amount$� Tax Service (OD9-JUN-2 IIIIII�II�I�II�II�III�iII�iIIII�IIIII�IIII!«ILII CPF Tax Due $ Agency Verification — --- Improved. 6 Satisfactions/Discharges/Releases List Property Owners Ma€ling Prddress RECORD&RETURN TO: Vacant Land 5�?NcQr .4 �4i e5h� ESQ TD TD Soca rkol�D, N�{ 11971 TD Mail to:Judith A. Pascale,Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffolkcountyny.gov/clerk Title# o Y- 13s Y o 8 Suffolk County Recording & Endorsement Page This page forms part of the attached I made by: (SPECIFY TYPE OF INSTRUMENT} tor,,'-e- ,✓de, o,). Ga'G T A.vder50.j The premises herein Is situated in I<T. Avcicrsa v /yl 4r,�,; S rr,4,�Z SUFFOLK COUNTY,NEW YORK. TO In the TOWN of <sEk—1-k0 I�t %r or F;;r ' LLC In the VILLAGE _ or HAMLET of i✓40r' BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. over '7yOq �,ONSULT OUR LAWYER FORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYER L Bargain and Sale Deed, with Covenant against Grantor's Acts 7k THIS INDENTURE,made the Q day of April,2022 BETWEEN LORRIE ANDERSON,CRAIG T.ANDERSON,MARK T.ANDERSON,and MARNIE STRANZ Lorrie Anderson: Residing at 616 Stillmeadow Drive,Richardson TX 75081 Craig T.Anderson:Residing at 801 W.5th Street,#1907,Austin TX 78703 Mark T Anderson:Residing at Box 1385, Emory TX 75440 Marnie Stranz: Residing at 5918 Independence Court, Rowlett TX 75089 party of the first part,and BLUEBIRD NORTH FORK LLC, Residing at 209 W 97 Street, New York NY 10025 party of the second part, WITNESSETH,that the party of the first part,in consideration of$1,300,000.00 dollars paid by the party of the second part,does hereby grant and release unto the party of the second part, the heirs or successors and assigns of the party of the second part forever, ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the Being known and designated as: District: 100,Section.035.00,Block 01.00,Lot 027.002 SEE ATTACHED SCHEDULE"A" BEING AND INTENDED TO BE the same premises described in a deed made by Frank Justin McIntosh and Mark T.Anderson, Trustees of the Frank McIntosh Qualified Personal Residence Trust dated June 25, 2002 recorded September 6,2002 in the Suffolk County Clerk's Office in Liber 12207 page 446. TOGETHER with all right, title and interest, if any, of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof; TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises;TO HAVE AND TO HOLD the premises herein granted unto the party of the second part,the heirs or successors and assigns of the party of the second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever,except as aforesaid. AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement before using any part of the total of the same for any other purpose. The word"party"shall be construed as if it read"parties"whenever the sense of this indenture so requires. IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above written. 1N PRESENCE OF: LORRIE ANDERSON CRWTANRO�f MARK T.ANDERSON MARNIE STRANZ CONSULT=LAWYER BORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY rT Bargain and Sale Deed, with Covenant against Grantor's Acts THIS INDENTURE,made the l�' day of April,2022 j� Yld��' , 11 BETWEEN rX �� LORIE AnderDERSON,CRAIG T.ANDERSON,MARK T.ANDERSON,and MARNIE STRANZ Louie As : Residing at 616 Stiilmeadow Drive,Richardson TX 75081 Craig T Anderso :Residing at 801 W.5th Street,#1907,Austin TX 78703 Mark T.Anderson: esiding at Box 1385, Emory TX 75440 Marnie Stranz: Resi ' g at 5918 Independence Court, Rowlett TX 75089 party of the first part,an BLUEBIRD NORTH FORK L C, Residing at 209 W 97 Street, w York NY 10025 party of the second part, WITNESSETH,that the party of the first pa in consideration of$1,300,000.00 dollars paid by the party of the second part, oes hereby grant and release unto the party of the second part, the heirs or successors and assigns of the part of the second part forever, ALL that certain plot, piece or parcel of land, with It buildings and improvements thereon erected, situate, lying and being in the Being known and designated as: District: 1000,Section.03 00,Block 01-00,Lot 027.002 SEE ATTACHED SCHEDULE"A" BEING AND INTENDED TO BE the same premises described in a dee made by Frank Justin McIntosh and Mark T. Anderson, Trustees of the Frank McIntosh Qualified Personal R idence Trust dated June 25, 2002 recorded September 6,2002 in the Suffolk County Clerk's Office in Liber 122 7 page 446. TOGETHER with all right, title and interest, if any, of the party of the first part in nd to any streets and roads abutting the above described premises to the center lines thereof, TOGETHER with the appurtenances and all the estate and rights of the party of the i st part in and to said premises;TO HAVE AND TO HOLD the premises herein granted unto the party of the se nd part,the heirs or successors and assigns of the party of the second part forever. AND the party of the first part covenants that the party of the first part has not done or su red anything whereby the said premises have been encumbered in any way whatever,except as aforesaid. AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the pa of the first part will receive the consideration for this conveyance and will hold the right to receive such conside tion as a trust fund to be applied first for the purpose of paying the cost of the improvement before using any p . of the total of the same for any other purpose. The word"party"shall be construed as if it read"parties"whenever the sense of this indenture so requires. IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF: s r L RIEANDERSON CRAIG T.ANDERSON %MARKT.AD�RSONIE STRANZ OONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY Bargain and Sale Deed, with Covenant against Grantor's Acts THIS INDENTURE,made the day of April,2022 5it �VV$ BETWEEN LO RIE ANDERSON,CRAIG T.ANDERSON, MARK T.ANDERSON,and MARNIE STRAW Lord nderson: Residing at 616 Stillmeadow Drive,Richardson TX 75081 Craig T. nderson:Residing at 801 W.5th Street,#1907,Austin TX 78703 Mark T.A erson:Residing at Box 1385,Emory TX 75440 Marnie Stra : Residing at 5918 Independence Court, Rowlett TX 75089 party of the first rt,and BLUEBIRD NORTH ORK LLC, Residing at 209 W 97 reet, New York NY 10025 party of the second part, WITNESSETH,that the party of th Irst part,in consideration of$1,300,000.00 dollars paid by the party of the seco part,does hereby grant and release unto the party of the second part, the heirs or successors and assigns of e parry of the second part forever, ALL that certain plot, piece or parcel of Ian , with the buildings and improvements thereon erected, situate, lying and being in the Being known and designated as'. District: 1000, Se 'on.035.00, Block 01.00, Lot 027.002 SEE ATTACHED SCHEDULE'W BEING AND INTENDED TO BE the same premises describe i a deed made by Frank Justin McIntosh and Mark T.Anderson, Trustees of the Frank McIntosh Qualified Pe onal Residence Trust dated June 25, 2002 recorded September 6,2002 in the Suffolk County Clerk's Office in 'ber 12207 page 446. TOGETHER with all right, title and interest, if any, of the party of the fi t part in and to any streets and roads abutting the above described premises to the center lines thereof; TOGETHER with the appurtenances and all the estate and rights of the pa of the first part in and to said premises;TO HAVE AND TO HOLD the premises herein granted unto the pa f the second part,the heirs or successors and assigns of the party of the second part forever. AND the party of the first part covenants that the party of the first part has not ne or suffered anything whereby the said premises have been encumbered in any way whatever,except as afo said. AND the party of the first part, in compliance with Section 13 of the Lien Law,covenants at the party of the first part will receive the consideration for this conveyance and will hold the right to receive s h consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement before sing any part of the total of the same for any other purpose, The word"party"shall be construed as if it read"parties"whenever the sense of this indenture so requires. IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF: LORRIE ANDERSON I ►tel l� � 2� CRAIG T.ANDERSON MARK T.ANDERSON MARNIE STRANZ FIpELITY NATIONAL TITLE INSURANCE COMPANY TITLE NO.7404-013540 SCHEDULE A-1 (Description of the Land) For Tax Map ID(s): 1000-035.00-01.00-027.002 ALL that certain plot,piece or parcel of land,situate,lying and being near Greenport,Town of Southold,County of Suffolk, Statelof New York,bounded and described as follows: BEGINNING at a monument set in the Northerly line of North Road(opposite the Sterling Cemetery)at the Southwesterly corner of the premises herein described and adjoining land now or formerly of Peconic Landing at Southold Inc.; RUNNING THENCE along said last mentioned land the following three courses and distances: 1.North 19 degrees 16 minutes 00 seconds West 344.83 feet; 2.North 72 degrees 25 minutes 20 seconds East 169.21 feet;and 3.South 11 degrees 31 minutes 10 seconds East 331.33 feet to the Northerly line of the North Road; THENCE South 66 degrees 01 minute 20 seconds West along the Northerly line of the North Road 8.73 feet;and I THENCE South 65 degrees 23 minutes 50 seconds West along the Northerly line of the North Road 116.27 feet to the pointior place of BEGINNING. THEI POLICY TO BE ISSUED under this commitment will insure the title to such buildings and improvements on the premises which by law constitute real property. FOR CONVEYANCING ONLY: Together with all the right,title and interest of the party of the first part,of in and to the land lying in the street in front of and adjoining said premises. END OF SCHEDULE A Printed:02.25.22 Q 09:13 AM Carnmitment ter Title Insurance NY-FT-FRVH-01030.431004-SPS-1-22-7404-013540 Schedule A-1 Description I State of Texas,County of State of Texas,County of ss: ss: On the day of April in the year 2022 On the day of April in the year 2022 before me,the undersigned,personally appeared before me,the undersigned,personally appeared LORRIE ANDERSON CRAIG T.ANDERSON personally known to me or proved to me on the basis of personally known to me or proved to me on the basis of satisfactory evidence to be the individuals) whose satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and name(s) is (are) subscribed to the within instrument and acknowledged to me that helshelthey executed the same acknowledged to me that helshe/they executed the same in his/her/their capacity(ies), and that by his/her/their in his/her/their capacity(ies), and that by hislherltheir signature(s) on the instrument, the individual(s), or the signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, person upon behalf of which the individual(s) acted, executed the instrument. executed the instrument. (signature and office of individual taking acknowledgment) (signature and office of individual taking acknowledgment) State of Texas,County of Rimn's ss: On the!Tday of April in the year 2022 before me,the undersigned,personally appeared MARK T,ANDERSON personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)is (are)subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hislherltheir capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or a person upon behalf of which the individual(s)acted,executed the instrument. (signature nd office of individual taking acknowledgment) State of Texas,County oflvlrl�►'�L ss: s�"'��'tr�yy., SYDNE ROMINE .INotary Public,State of Texas On the day of April in the year 2022 y31; e Comm.Expires 011-112-2026 before me,the undersigned,personally appeared %;��a� `�� Notary ID 13353184-0 MARNIE STRANZ personalty known to me or proved to me on the basis of satisfactory evi ence o ehe individual(s)whose name(s)is (are)subscribed to the within instrument and acknowledged to me that helshelthey executed the same in his/herltheir capacity(ies), and that by hislherltheir signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s)acted,executed the instrument. (signature and office of individual taking acknowledgment) Bargain and Sale Deed WITH COVENANT AGAINST GRANTOR'S ACTS DISTRICT 1000 SECTION 035.00 BLOCK 01.00 LOT 027.002 COUNTY OR TOWN Suffolk STREET ADDRESS 2345(Main Road,Greenport NY 11944 RETURN BY MAIL TO: Sandra Saiegh,Esq. 53740 Main Road PO BOX 225 Southold,NY 11971 RESERVE THIS SPACE FOR USE OF RECORDING OFFICE State of Texas,County of �Gll�t State of Texas.County of �y SS: ss: On the VD day of April in the year 2022 On the day of April in the year 2022 before me,the undersigned,personally appeared before me,the CRAIG T.ANDERSON undersigned,personally appeared LORRIE ANDERSON personally known to me or proved to me on the basis of personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same acknowledged to me that helshelthey executed the same in hislherltheir capacity(ies), and that by his/her/their in hislherltheir capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, person upon behalf of which the individual(s) acted, executed the instrument. executed the instrument. (signature and office of in iv' king acwafillewRm" (si ature and office of individual taking acknowledgment) z Notary Public,State of Texas a,i +.^z Comm.Expires 11-03-2026 Note ry ID 133429191 State of Texas,County of ss: On the day of April in the year 2022 before me,the undersigned,personally appeared MARK T.ANDERSON personally known to me or proved to me on the basis of satisfactory evidence to be the individuals)whose name(s)is (are)subscribed to the within instrument and acknowledged to me that he/she/they executed the same in hislherltheir capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s)acted,executed the instrument. (signature and office of individual taking acknowledgment) State of Texas,County of 'Qc,,"A> ss: On the tlgay of April in the year 2022 before me,the undersigned,personally appeared MARNIE STRANZ personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)is (are)subscribed to the within instrument and acknowledged to me that he/shelthey executed the same in hislherltheir capacity(ies), and that by hislherltheir signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s)acted,executed the instrument. /y (signature and of indiOdual taking acknowledgment) FRED GORDON Bargain and Sale Deed ;Notary Public,State ofTaxes WITH COVENANT AGAINST GRANTOR'S ACTS Comm.Expires 11-03-2025 Notary 10 133429191 DISTRICT 1000 SECTION 035.00 BLOCK 01.00 LOT 027.002 COUNTY OR TOWN Suffolk STREETADDRESS 2345 Main Road,Greenport NY 11944 RETURN BY MAILTO: Sandra Saiegh,Esq. 53740 Main Road PO BOX 225 Southold,NY 11971 RESERVE THIS SPACE FOR USE OF RECORDING OFFICE State of Texas,County of State of Texas,County of Uvlk� ' ss: ss: T, On the day of April in the year 2022 On the'Pday of April in the year 2022 before me;the undersigned,personally appeared before me,the undersigned,personally appeared LORRIE ANDERSON CRAIG T.ANDERSON personally known to me or proved to me on the basis of personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same acknowledged to me that helshe/they executed the same in his/her/their capacity(ies), and that by his/her/their in his/her/their capacity(ies), and that by hislhedtheir signature(s) on the instrument, the individual(s), or the signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, person upon behalf of which the individual(s) acted, executed the instrument. exercd the instrument. _ � k- (signature and office of individual taking acknowledgment) igna ru anddooff(L( Jjjtdivdual taking acknowledgment) �plYlplry`�LCHAD RONALD COLLINS Notary Public,State of Taxes M .%*.E Comm.Expires 05-20-2023 State of Texas,County of Notary ID 132019475 SS: On the day of April in the year 2022 before me,the undersigned,personally appeared MARK T.ANDERSON personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)is (are)subscribed to the within instrument and acknowledged to me that helshe/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s)acted,executed the instrument. (signature and office of individual taking acknowledgment) State of Texas,County of SS: On the day of April in the year 2022 before me,the undersigned,personally appeared MARNIE STRANZ personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)is (are)subscribed to the within instrument and acknowledged to me that helshelthey executed the same in his/herltheir capacity(ies), and that by his/herltheir signature(s) on the instrument, the individual(s), or the person upon behalf of which the individuals)acted,executed the instrument. (signature and office of individual taking acknowledgment) Bargain and Sale Deed WITH COVENANT AGAINST GRANTOR'S ACTS DISTRICT 1000 SECTION 935.00 BLOCK 01.00 LOT 027.002 COUNTY OR TOWN Suffolk STREETADDRESS 2345 Main Road,Greenport NY 11944 RETURN BY MAILTO: Sandra Saiegh,Esq. 53740 Main Road PO BOX 225 Southold,NY 11971 RESERVE THIS SPACE FOR USE OF RECORDING OFFICE INSTRUCTIONS(RP-5217-PDF-INS):wtvw.orps.state.ry us FOR COUNTY USE ONLYNew York State Department of C1.SVVIS Code ��„�5- 0--6; 1 Taxation and Finance 6.Date Deed Recorded -j' ! t Office of Ree.!Property Tax Sol vicus RP-5217-PDF C3.Book LL-5: , C4.Pago I I �l Real Property Transfer Roport(8110) PROPERTY INFORMATION 1.Property ,�,;;; I•'a i n Road Location •hr4CC1NJMJbr •s'M1p -.c G r o on tar z 194.1 c.-C.Ic.'h Ve tAriC •r p Cont 2.Buyer rd Nrj=L" ):O!".-: TIT.0 Name 'NST hM,ET:C.M��M1Y FrrS'NAw= ./IS-NAw■.faA:AY+ •_ - :•geT NAM. __- � 3.Tax Ind;ca:e who•e'uwra Tax B:Ils a e m be scr: Billing f ether lhar:luy'or adcruss(al boUu^of lune) :AS-•IAwE,00161-4- rlrsl-P%C Address 5;ALF:rrw:e,,t AA},NAK C-•O4TMIN STATF tlr CODE 4.Indicate the number of Assessment ) L J Part of a Parcel (Only if Part or a Parcel)Chock as they apply: Roll parcels transferred on the deed. ___�cf Pararls pR 4A.planning Boar)w.th Subclvislcn Authority txls:s S.Dred OR -•1 Property `F'r 4B.Suadivision Approval was RegJlreu for Transfer J •Fico.- •Craw„ -�;-F4. _ . ... .- Size 4C.Parcel Approve.-fo•Saadlvls•on with Map ProvAnd :Lf:dBY tOt'. Lome. Crniy T. d [bark T 6.Seller •�Ati:NnwY4Ow+AhY FWNFLAME Name St-3.^.Z MF^n.ir tAsr L-CCoNa.nr ---'------- Fp-.%r hR4C - -•-- '7.Select the description which most accurately describes the Check the boxes below as they apply: use of the property at the time of sale: 8.Owrership Type is Ccr:cominium 1 A.Ona Famik-Residential 9.New Corsu:,C•ran On a Voc:nt Lur,u J -----•----- - 10A.Prope•:y LCW10 within an Agrimila'all DIS:nCL L J 100.BJyer roceived a discosire relca indi11aling that the pr000rty is 1111.an Agriru:tura!District LI SALE INFORMATION1 15.Chock one or more of these conditions as applicable to transfer: A' Sa a Between Relal:vea o•Fanner Relatives 11.Sale Contract Data 02/08/2021 B.Sale oo.weer.Related Companies or Partners In Bus.noss ---- C.One.of the Buyers.s also a Sealer 12.Data of Salorrransfor 04/28/2,022 _ D.Buyer or Seller Is Gove•nmont Agarcy or Lending Institution E.Daec Type not Warranty or Bargain and Sale(Specify Below) I 'F Sale of FraC1iO'13l or LUSS L•1An Foe Interest(Specify Below) Full Sale Price ,30n,0,)0.I)t) �_G.Significant Cnargo in Property Between Taxao'e Status and Sale Dates '-' H Salo of Business Is Induced m Sale Price (Fu:l Sale Price is the total amount pale fa the proubrty tnc!Ldirg personal property ' I. O:•Icr unusual Factors Affect ng So:e Price(Specify Below) This payr+em may ae In the torm of cash,over property or goods,or the assn-ctior of J None rror:gages or ober cbl gatiors.)Please rcuner to the nearest wtiva dbrtar amount. Comment(s)on Condition: 14.Indicate the value of personal property included in No sale 0 •f)U ASSESSMENT INFORMATION-Data should reflect the latest Final Assessment Roll and Tax BIII 16.Year of Assessment Roll from which information taken(YY) 22 '17.Total Assessed Value '18.Property Class 210 _ -19.School District Name G-eenr o r.•: '20.Tax Map ldenllfier(e)iRoll tdentifrer(s)(if more than four,attach shoat with additional identlnor(s)) _031-15.0(1-1113.4.111-0.27.;:0: CERTIFICATION I Certify that all of the Items of information entered on this form are true and correct(to the best of my knowledge and belled)and 1 understand that the making of any willful false statement of material fact herein subject me to lheJ,MyjsI0r19_eLthe.pena4latv_relative to the making and filing of false instruments. SELLLEjL,JJC,NAT1JRE BUYER CONTACT INI=ORKAILQN (Fetor i•ItC.% 01x1 1u:tie by6ial H i r 1-buy'.is hr.r a n-re as conic•:.donranor c•or.:nciv ulibms ny,sitki.d �• rI•:IIy IIIc:a,x aY.Ild.v.eaal apenl x'rll.e:ly.Isar a naY1c arc:a�Iac:IMamw:xrr U or ireirtAtaFrcaptxlslNe j� ;..,ww ear a'lseer grar,Lo's ragardha 2w I:aratw nibs'!-a orim-ed Type Or print clearly.) CLLCn S5h.JR: BUYBR'S URI; .Ve HSI NANL ..NEA'X., -reL!•1•w IN rd.WFF tL•,x/k rM,_ ' 6l:rEq S.:dL\TWTC -Roy to 114 ,rr}YJws=a 'S14EEThAML ^17. BUYER'S.ATTORNEY + I i,neern Sa na ra 11'i'- 8 � ' )I a I I � .11 � r.' I � III I (y 3))-Nae 1 6 9-T?r..A