HomeMy WebLinkAboutL 12891 P 810 �IIIIIIIIIIIVIIIIIIIIIIIDIIIIIIIIIIVIIIVIIIIIIIIIII
I I I I I I I I I I I I I I l
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 12/09/2016
Number of Pages : 7 At: 02 :01 : 44 PM
Receipt Number : 16-0195717
TRANSFER TAX NUMBER: 16-14405 LIBER: D00012891
PAGE : 810
District: Section: Block: Lot:
1000 056 . 00 01 . 00 011 .014
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $1, 125, 000 . 00
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $35 . 00 NO Handling $20 . 00 NO
COE $5 . 00 NO NYS SRCHG $15 . 00 NO
EA-CTY $5 . 00 NO EA-STATE $250 .00 NO
TP-584 $5 . 00 NO Notation $0 . 00 NO
Cert.Copies $0 . 00 NO RPT $600 . 00 NO
Transfer tax $4, 500 . 00 NO Comm.Pres $21,000 . 00 NO
Fees Paid $26, 435 .00
TRANSFER TAX NUMBER: 16-14405
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
RECORDED
2016 Dec 09 02:01:44 PM
JUDITH R. PRSCRLE
Number of pages CLERK OF
SUFFOLK COUNTY
L D00012891
P 810
This document will be public DT# 16--14405
record. Please remove all
Social Security Numbers
prior to recording.
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 1 FEES
r Mortgage Amt.
Page/Filing Fee
1. Basic Tax
Handling 20. 00
2. Additional Tax _
TP-584 Sub Total
Notation Spec./Assit.
or
EA-52 17(County) Sub Total Spec./Add.
EA-5217(State TOT.MTG.TAX —
r/J�
R.P.T.S.A. Dual Town Dual County_
�v OD
Held for Appointment N�
Comm.of E 5. 00 Transfer Tax rW
�
Mansion Tax
Affidavit y� —
The property covered by this mortgage is
Certified Copy or will be improved by a one or two
NYS Surcharge 15. 00 Sub Total bD family dwelling only.
YES or NO
Other
Grand Total If NO,see appropriate tax clause on
page# of his rostrum nt.
4 1 Dist. 16036246 ��. S Community Preservation Fund
Real Propel RTS lIIII IFI II IIII III II��III�II I�Illlllllll CPF Tax Due deration Amount$ +x
Tax Servo R OTY A I J
Agency 22-NOV-1 $
24,em
Verificatic
Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
// RECORD&RETURN TO: Vacant Land
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Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Companx Information
310 Center Drive, Riverhead, NY 11901 Nae I/SP2I c1
www.suffolkcountyny.gov/clerk Title# 7
y 3
8 Suffolk Countj Recording & Endorsement Pa e
This page forms part of the attached 40e-ra made by:
/ (SPECIFY TYPE OF INSTRUMENT)
n q�` 1410&,�/L The premises herein is situated in
SUFFOLK COUNTY,NEWjc/4'YORK. /
T In the TOWN of '
�C
14 In the VILLAGE
!iR or HAMLET of
BOXES 6 THRU S MUST BE TYPED OR PRIN'rLD IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
II-0104,1a/oskk
(over)
T
~' R DTY A
Doc ID: 16036246
2-NOV-1f
Tax Maps
District Secton Block Lot School District Sub Division Name
1000 05600 0100 011003
1000 05600 0100 011014
1000 05600 0100 011015
—Bargain and Sale Deed,with Covenant against Grantor's Acts—Individual or Corporation(Single Sheet)
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT—THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY.
S
THIS INDENTURE,made the 26th day of JULY,in the year 2016
BETWEEN ANGELA NORTON as surviving spouse of Edward T.Ernst,deceased,who died on 04/22/2011,residing at
61025 Main Road,Southold,NY 11971
JyNvSAw�
party of the first part,and Gerard Murtha and Robin MurthaA
,rest mg at 4[ 1wIF East ke Drive,Montauk,NY 11954
party of the second part,
WITNESSETH,thafthe party of the first part,in consideration of
10.00 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,being part of the premises described in deed dated 7/27/2001 and recorded
8/2/2001 in Liber 12133,Page 681.
SEC:
056.00 ALL that certain plot,piece or parcel of land,with the buildings and improvements thereon erected,situate,lying and being
in the SEE ATTACHED LEGAL DESCRIPTION
Block:
01 .00 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
Lot: rights of the party of the first part in and to said premises;TO HAVE AND TO HOLD the premises herein granted unto the
O 11 .0 0 3party of the second part,the heirs or successors and assigns of the party of the second part forever.
01 1 .014 AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said
g premises have been encumbered in any way whatever,except as aforesaid.
Q 1 SAND 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 and will apply the same first to the payment of 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.
IN PRESENCE OF:
Angela N on
.t
ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE
State of New York,County of Suffolk,ss: State of New York,County of ss:
On the 26th day of July in the year 2016,before me,the undersigned, On the day of in the year before me,the
personally appeared Angela Norton undersigned,personally appeared
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 name(s)is(are) satisfactory evidence to be the individual(s)whose name(s)is(are)
subscribed to the within instrument and acknowledged to me that subscribed to the within instrument and acknowledged to me that
he/she/they executed the same in his/her/their capacity(ies),and that by helshUthey executed the same in his/her/their capacity(ies),and that by
his/her/their signatures) th instrument,[he i tdual(s),or the his/her/their signature(s)on the instrument,the individual(s),or the
person upon behalf of is a indi idu acted,executed the person upon behalf of which the individual(s)acted,executed the
instrument. instrument.
W HUGHE
NOTApY PUBLI TATE OF NEW YORK
peglstration No.01 HU61028M
Ouallfied in Nassau County.
commission 6 Tres December 820
ACKNOWLEDGEMENT BY SUBSCRIBING WITNESS TAKEN ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK
IN NEW YORK STATE STATE
State of New York,County of ss: *State of County of ss:
*(Or insert District of Columbia,Territory,Possession or Foreign
On the day of in the year before me,the County)
undersigned,a Notary Public in and for said State,personally appeared
the subscribing witness to the foregoing instrument,with whom On the day of in the year before me the
1 am personally acquainted,who,being by me duly swom,did depose undersigned personally appeared
and say that helshe/they reside(s)in
Personally known to me or proved to me on the basis of satisfactory
(if the place of residence is in a city,include the street and street number if any,thereof): evidence to be the individual(s)whose name(s)is(are)subscribed to the
that helshe/they know(s) within instrument and acknowledged to me that helshe/thcy executed the
same in his/her/their capacity(ics), that by his/her/their signature(s)on
to be the individual described in and who executed the foregoing the instrument,the individual(s)or the person upon behalf of which the
instrument;that said subscribing witness was present and saw said individual(s)acted,executed the instrument,and that such individual
make such appearance before the undersigned in the
execute the same;and that said witness at the same time subscribed
his/her/their name(s)as a witness thereto (add the city or political subdivision and the state or country or other .
place the acknowledgement was taken).
Bargain and Sale Deed
With Covenants
SECTION:056.00
BLOCK:01.00
Title No.EAM112743S LOT:011.003,011.014and 011,015
COUNTY OR TOWN:Suffolk
NORTON
TO
MURTHA
RETURN BY MAIL TO:
Peter T.Roach
DISTRIBUTED BY Peter T.Roach&Associates, P.C.
6901 Jericho Turnpike
Suite 240
YOUR TITLE EXPERTS Syosset,NY 11791
The Judicial Title Insurance Agency LLC
800-281-TITLE(8485) FAX:800-FAX-9396
Old Republic Title Insurance CompanyNY
SCHEDULE A
DESCRIPTION OF PREMISES
Title No. EAM112743S
ALL that certain plot, piece or parcel of land situate, lying and being in the Town of Southold, County of Suffolk,
State of New York, being known and designated as Lot 5"Mill Creek Preserve"filed in the Office of the Clerk of
Suffolk County January 28, 2005 as File Number 11216.
Beginning at the Point and or place of Beginning; Said point being on the southerly line of a 50 foot Right of Way
and at the northwest corner of Lot 5 and northeast corner of Lot 4 Map of"Mill Creek Preserve" the following
courses and distances from a monument at the Northwesterly corner of Lot 4 on the above mentioned map and the
southeasterly terminus of Long Creek Drive. Running along the southerly line of the 50 foot Right of Way, North 58
degrees 04 minutes 13 seconds East, a distance of 4.37 feet, to the beginning of a curve to the right tangent to the
previous course with Radius 50.00 feet and Are Length 59.60 feet; thence through a curve to the left with a Radius
of 100.00 feet and Arc Length 88.89 feet; thence North 75 degrees 25 minutes 53 seconds East, a distance of
217.43 feet to the above mentioned northwest corner of Lot 5.
Running thence along the southerly side of a 50' ROW the following three courses and distances
1. North 75 degrees 25 minutes 53 seconds East, a distance of 265.66 feet;
2. South 36 degrees 58 minutes 00 seconds East, a distance of 52.50 feet;
3. North 75 degrees 25 minutes 53 seconds East, a distance of 50.00 feet; to the southwesterly corner of Lot
3;
Thence along Lot 3 the following three (3) courses and distances:
1. North 67 degrees 00 minutes 33 seconds East, a distance of 329.36 feet;
2. North 40 degrees 13 minutes 58 seconds West, a distance of 145.09 feet;
3. North 12 degrees 29 minutes 16 seconds West, a distance of 227.81 feet to the average high water mark of
Arshamomaque Pond;
Thence along the average high water mark of Arshamomaque mond the following fifteen (15) courses and
distances:
1. North 16 degrees 56 minutes 03 seconds West, a distance of 154.94 feet;
2. North 22 degrees 04 minutes 03 seconds East, a distance of 157.54 feet;
3. North 40 degrees 58 minutes 02 seconds East, a distance of 189.28 feet;
4. South 28 degrees 03 minutes 07 minutes East, a distance of 131.60 feet;
5. North 86 degrees 51 minutes 58 seconds East, a distance of 135.10 feet;
6. North 30 degrees 10 minutes 14 seconds West, a distance of 252.56 feet;
7. North 82 degrees 30 minutes 43 seconds East, a distance of 227.95 feet;
8. South 71 degrees 59 minutes 44 seconds East, a distance of 595.20 feet;
9. South 32 degrees 02 minutes 33 seconds East, a distance of 319.28 feet;
10. South 77 degrees 11 minutes 58 seconds West, a distance of 314.47 feet;
11. North 77 degrees 31 minutes 17 seconds West, a distance of 320.44 feet;
12. South 18 degrees 50 minutes 53 seconds West, a distance of 155.56 feet;
13. South 64 degrees 21 minutes 34 seconds East, a distance of 101.15 feet;
14. South 30 degrees 58 minutes 24 seconds East, a distance of 233.80 feet;
15. North 84 degrees 36 minutes 21 seconds East, a distance of 141.27 feet to Land of the Town of Southold;
Thence along said land of the Town of Southold the following four(4) courses and distances:
1. South 48 degrees 50 minutes 33 seconds West, a distance of 211.31 feet to a monument
2. South 14 degrees 26 minutes 27 seconds East, a distance of 47.18 feet;
3. South 05 degrees 58 minutes 37 seconds East, a distance of 87.71 feet;
4. South 04 degrees 44 minutes 43 seconds West, a distance of 417.25 feet to Land of the County of Suffolk;
Thence South 68 degrees 23 minutes 03 seconds West, a distance of 96.80 feet;
Thence South 30 degrees 51 minutes 17 seconds East, a distance of 699.63 feet to the Northerly line of"Old Mill
Bath%
Thence along said Northerly line of"Old Mill Path" the following three(3) courses and distances:
1. North 67 degrees 44 minutes 43 seconds East, a distance of 177.12 feet;
2. North 79 degrees 14 minutes 43 seconds East, a distance of 224.90 feet;
3. North 51 degrees 27 minutes 43 seconds East, a distance of 39.57 feet;
Thence South 39 degrees 43 minutes 54 seconds East a distance of 10.94 feet to the southerly side of"Old Mill
Path";
Old Republic Title Insurance CompanyNY
SCHEDULE A
DESCRIPTION OF PREMISES continued
Thence along said Southerly line of"Old Mill Path" the following three (3)courses and distances;
1. South 51 degrees 27 minutes 43 seconds West a distance of 41.13 feet;
2. South 79 degrees 14 minutes 43 seconds West a distance of 226.37 feet;
3. South 67 degrees 44 minutes 43 seconds West a distance of 208.00 feet to the easterly line of Lot 1 as
shown on a certain map filed in the Office of the Clerk of Suffolk County as Map Entitled"James Patrick
Kelly'filed March 18, 1992 as File Number 9199;
Thence along the easterly and northerly line of Lot 1 the following two(2) courses and distances:
1. North 30 degrees 51 minutes 17 seconds West, a distance of 709.39 feet to a pipe;
2. South 68 degrees 01 minute 23 seconds West, a distance of 70.00 feet to a pipe;
Thence South 43 degrees 19 minutes 33 seconds West, a distance of 471.25 feet to a pipe;
Thence South 31 degrees 05 minutes 27 seconds East, a distance of 247.19 feet to the northerly line of Lot 6 on
Map of Mill Creek Preserve;
Thence South 63 degrees 04 minutes 13 seconds West, a distance of 557.20 feet to a point on the easterly
terminus of Pond Avenue;
Thence along the easterly terminus of Pond Avenue and also along the easterly line of a certain subdivision Known
as "Map of Long Pond Estates - Section One" said map filed in the Office of the Clerk of Suffolk County December
27, 1985 as File No. 8037, North 26 degrees 55 minutes 47 seconds West, a distance of 1165.10 to the Southwest
corner of Lot 4 as shown on Map of Mill Creek Preserve;
Thence along the southerly and easterly line of Lot 4 the following courses and distances:
1. North 63 degrees 04 minutes 13 seconds East, a distance of 300.00 feet;
2. North 14 degrees 34 minutes 07 seconds West, a distance of 157.41 feet to the above mentioned Point and
or place of BEGINNING.
Excepting therefrom all of that tax lot known as District 1000 Section 056.00 Block 01.00 Lot 011.013.
Old Republic Title Insurance CompanyNY
i
SCHEDULE A
DESCRIPTION OF PREMISES
Title No. EAM 112743S
ALL that certain plot, piece or parcel of land situate, lying and being in the Town of Southold, County of Suffolk,
State of New York, being known and designated as Lot 5"Mill Creek Preserve"filed in the Office of the Clerk of
Suffolk County January 28, 2005 as File Number 11216.
Beginning at the Point and or place of Beginning; Said point being on the southerly line of a 50 foot Right of Way
and at the northwest corner of Lot 5 and northeast corner of Lot 4 Map of"Mill Creek Preserve"the following
courses and distances from a monument at the Northwesterly corner of Lot 4 on the above mentioned map and the
southeasterly terminus of Long Creek Drive. Running along the southerly line of the 50 foot Right of Way, North 58
degrees 04 minutes 13 seconds East, a distance of 4.37 feet, to the beginning of a curve to the right tangent to the
previous course with Radius 50.00 feet and Arc Length 59.60 feet; thence through a curve to the left with a Radius
of 100.00 feet and Arc Length 88.89 feet; thence North 75 degrees 25 minutes 53 seconds East, a distance of
217.43 feet to the above mentioned northwest corner of Lot 5.
Running thence along the southerly side of a 50' ROW the following three courses and distances
1. North 75 degrees 25 minutes 53 seconds East, a distance of 265.66 feet;
2. South 36 degrees 58 minutes 00 seconds East, a distance of 52.50 feet;
3. North 75 degrees 25 minutes 53 seconds East, a distance of 50.00 feet; to the southwesterly corner of Lot
3;
Thence along Lot 3 the following three(3)courses and distances:
1. North 67 degrees 00 minutes 33 seconds East, a distance of 329.36 feet;
2. North 40 degrees 13 minutes 58 seconds West, a distance of 145.09 feet;
3. North 12 degrees 29 minutes 16 seconds West, a distance of 227.81 feet to the average high water mark of
Arshamomaque Pond;
Thence along the average high water mark of Arshamomaque Pond the following fifteen (15)courses and
distances: '
1. North 16 degrees 56 minutes 03 seconds West, a distance of 154.94 feet;
2. North 22 degrees 04 minutes 03 seconds East, a distance of 157.54 feet;
3. North 40 degrees 58 minutes 02 seconds East, a distance of 189.28 feet;
4. South 28 degrees 03 minutes 07 minutes East, a distance of 131.60 feet;
5. North 86 degrees 51 minutes 58 seconds East, a distance of 135.10 feet;
6. North 30 degrees 10 minutes 14 seconds West, a distance of 252.56 feet;
7. North 82 degrees 30 minutes 43 seconds East, a distance of 227.95 feet;
8. South 71 degrees 59 minutes 44 seconds East, a distance of 595.20 feet;
9. South 32 degrees 02 minutes 33 seconds East, a distance of 319.28 feet;
10. South 77 degrees 11 minutes 58 seconds West, a distance of 314.47 feet;
11. North 77 degrees 31 minutes 17 seconds West, a distance of 320.44 feet;
12. South 18 degrees 50 minutes 53 seconds West, a distance of 155.56 feet;
13. South 64 degrees 21 minutes 34 seconds East, a distance of 101.15 feet;
14. South 30 degrees 58 minutes 24 seconds East, a distance of 233.80 feet;
15. North 84 degrees 36 minutes 21 seconds E=ast, a distance of 141.27 feet to Land of the Town of Southold;
Thence along said land of the Town of Southold the following four(4) courses and distances:
1. South 48 degrees 50 minutes 33 seconds West, a distance of 211.31 feet to a monument
2. South 14 degrees 26 minutes 27 seconds East, a distance of 47.18 feet;
3. South 05 degrees 58 minutes 37 seconds East, a distance of 87.71 feet;
4. South 04 degrees 44 minutes 43 seconds West, a distance of 417.25 feet to Land of the County of Suffolk;
Thence South 68 degrees 23 minutes 03 seconds West, a distance of 96.80 feet;
Thence South 30 degrees 51 minutes 17 seconds East, a distance of 699.63 feet to the Northerly line of"Old Mill
Path";
Thence along said Northerly line of"Old Mill Path" the following three(3)courses and distances:
1. North 67 degrees 44 minutes 43 seconds East, a distance of 177.12 feet;
2. North 79 degrees 14 minutes 43 seconds East, a distance of 224.90 feet;
3. North 51 degrees 27 minutes 43 seconds East, a distance of 39.57 feet;
Thence South 39 degrees 43 minutes 54 seconds East a distance of 10.94 feet to the southerly side of"Old Mill
Path";
Old Republic Title Insurance CompanyNY
SCHEDULE A
DESCRIPTION OF PREMISES continued
Thence along said Southerly line of"Old Mill Path"the following three(3)courses and distances;
1. South 51 degrees 27 minutes 43 seconds West a distance of 41.13 feet;
2. South 79 degrees 14 minutes 43 seconds West a distance of 226.37 feet;
3. South 67 degrees 44 minutes 43 seconds West a distance of 208.00 feet to the easterly line of Lot 1 as
shown on a certain map filed in the Office of the Clerk of Suffolk County as Map Entitled "James Patrick
Kelly"filed March 18, 1992 as File Number 9199;
Thence along the easterly and northerly line of Lot 1 the following two(2)courses and distances:
1. North 30 degrees 51 minutes 17 seconds West, a distance of 709.39 feet to a pipe;
2. South 68 degrees 01 minute 23 seconds West, a distance of 70.00 feet to a pipe;
Thence South 43 degrees 19 minutes 33 seconds West, a distance of 471.25 feet to a pipe;
Thence South 31 degrees 05 minutes 27 seconds East, a distance of 247.19 feet to the northerly line of Lot 6 on
Map of Mill Creek Preserve;
Thence South 63 degrees 04 minutes 13 seconds West, a distance of 557.20 feet to a point on the easterly
terminus of Pond Avenue;
Thence along the easterly terminus of Pond Avenue and also along the easterly line of a certain subdivision Known
as "Map of Long Pond Estates -Section One" said map filed in the Office of the Clerk of Suffolk County December
27, 1985 as File No. 8037, North 26 degrees 55 minutes 47 seconds West, a distance of 1165.10 to the Southwest
corner of Lot 4 as shown on Map of Mill Creek Preserve;
Thence along the southerly and easterly line of Lot 4 the following courses and distances:
1. North 63 degrees 04 minutes 13 seconds East, a distance of 300.00 feet;
2. North 14 degrees 34 minutes 07 seconds West, a distance of 157.41 feet to the above mentioned Point and
or place of BEGINNING.
Excepting therefrom all of that tax lot known as District 1000 Section 056.00 Block 01.00 Lot 011.013.
INSTRUCTIONS(RP-5217-PDF-INS):www.orps.slatemy.us
FOR COUNTY USE ONLY
C1.SY48 Code L��n g 9 Ta York Slats Del3flrtfll of
I ! Taxation and Finance
C2.Date Deed Recordedy 9,�� Office of Real Property Tax Services
C3.Book I .101 Sly ca.P-9
a � RP-5277-PDF
�J Real Property Transfer Report(8110)
PROPERTY INFORMATION
f.Property 266:''• :.nng ;:ice:: ^rive
Location _. -
•:I'ALLTNVNerR _ •ST4LLr MLF
So;h L•1101 P.
_L1977.
-Z-,^
2.Buyer MLIR':'r.A
GERARD
Name '
Isar-L.VL,;uV�.xY - ,IRST X—L
MURTHA POBTN
—'JIs-N1ea-GVn4Nr rAS'e4VF
3.Tax Indicate where future Tax Bills are to be sent
Billing if other than buyer address(at bottom of form) IASI r..vr()+�
Address F14lI•'AVE
%1141.1-KAWQ AYJ HALF ,^:•(M TQAN SIAIE ,Ta CCA.'F
4.11rich aft the number of Assemment p d Parlxls ol��I (Only If Part are Parcell Cheek as they apply;
Roll parcels transferred on the dead 3_ OR LJ Part of o Parcel
M.Planning Boats with Subdivision Authority Exists
B.Dead
Properly _\ 011 45.6C n
. ,cy;. — 46.Subdivslan Approval was Required for Trenster
Slee —Wm -.rar5
4C-Parcel Approved kir Subdivision with Map Provided n
Naz ton ATtgola
6.Sailor LAST.44%zc rAV -
Nene
ee x41.C
-AST M,VA4e
'7.Select the description which moat accurately describes the Check the boxes below as they appy:
use of the Property at the time of sal.; S.Ownership Type Is Condominium
(.ReAde•.ntial Vacant tarn( 9.New Conssvction an a Vacant Land L]
10A-Property Located within an Agricultural Disaid CI
10B.Bearer received a disclosure notice indicating that the property,is In an
Agricultural oietrto CJ
SALE INFORMATION IL Check ons or more of them conditions es applicable to transfer.
r�A-Selo Between Relatives or Former Relatives
11.Sale Cordract Date 05/13/2016 B.Sale between Related Compelias or Partners in Business.
C.Ola el the Buyers 0 a" a Sellsr
•12.Dau of Saleft-rmfor 07/226/2016 D.Buyer or Seller Is Govumment Agency or Lending Institulkln
E.Deed Type not Warranty or Bargain and Sale(Specify Below)
F.Salo or Fractional or Loss then Fee Imorost(Specify Below)
M3.Full Sale Price 1,'-2!3,00w.00 G.Significant Change In Property Between Taxable Status aid Sale Dales
(Full Sale PrlCe ls the foul amouls id for the H Sale of Business Is Included In Sale Price
pa' prop"including personal assumption
I.Other Unusual Facies Affecting Sats Price(Specify Below)
Tlds payment may be in tilo farm of rash,other Ixooery o 9eoda,or the aswmptipl el J.Norse
mogages or other oblhetiens.)Please round to Ne nearest wick dolor anounit
Cammam(s)on Condition:
14.Indkau the value of personal
property Included In the sale Al
ASSESSMENT INFORMATION-Data should reflect the latest Final Assessment Roll and Tax Bill
18.Year of Asessamem Roll from which Information tekon(YY) 16 '17.Tat51 Assessed value •1,
*18.Property Clan 311 _ •_ '119.School District Name SO:,?-CLD —— ——
'20.Tax Map Idmmfflsr(sintall IdentlNer(a)(If more than four,attach shoat with additional Identifier(s)) --—
1v00,C56.VO,C1.OrJ,n11.003 10,111,056.00,O1.03,0!1.014 10 CC,056.00,CI.Cc,011.01Z
CER rIFICATION
I Cortiy that■11 ief the Sores at i limraatlan emend on this form are true and correct(to the bet of my knowledge and hellat)and I understand Had the making of any willful
fake statement of materiel fact herein subject me to the,pfpvNby,of tlyLperaLlaw-relative to the making and filing of hlse instruments.
SELLER.SIG!lATUgE VU`E&CQIyIACT INFOEWATJW
_ amw-n--inkintathetRyG•N.7a:YlN1yLYR:LC.reOegr.assad87PI,Cppa�llp'.JWIILaIeCL rAnpany.Csrale n!
/ curry that Is re:an ndwLWe aper,a F.ducarr.men a npTw and contact In'ix um d sr ndvixlraaespxmahe
a Pe b who car a:swer xuss:ae reaarxL+g the:nl shin•nus:tie m—d Type or print twit 1
SF.I I e Sr .114 >. (rFO
WYER_S)SNATMU MURTI',P. GERARD
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