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Buyer/Seller
<br /> A. Settlement Statement Settlement Statement
<br /> B.Type of Loan
<br /> Q 1.FHA 'Q 2,FmHA Q 3.Conv.Unins. 8.File Number T.Loan Number 8. Mortg,Ins.Case-Num.
<br /> Q 4.V.A. 0 5."Com.ins. 10036
<br /> ID:
<br /> C. NOTE:This form•is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agent are shown.Items
<br /> marked'(p.o.cj"ware paid outside the closing;they are shown here for informational purposes and are not included in the totals.
<br /> D:NAME OF BUYER: Indian River County,a Political Subdivision of the State of Florida
<br /> Address of Buyer: 1801 27th Street,Bldg A.,Vero Beach,Florida 32960
<br /> ,E,NAME OF SELLER: Michael J.Giessert and Lisa B.Giessen,husband and•wife
<br /> Address of Seller P.O.Box 402,Vero Beach.Florida 32961 TIN:
<br /> F.NAME OF LENDER:
<br /> Address of Lender:
<br /> G.PROPERTY LOCATION: 2625 54th Avenue,Vero Beach,Florida 32966
<br /> 14.SETTLEMENT AGENT: Collins,Brown,Barkett,Garavaglia&Lawn,Chartered TIN:59.1795861
<br /> Place of Settlement: 756 Beachland Boulevard,Vero Beach,Florida 32963 Phone:772-231.4343
<br /> 1, SETTLEMENT DATE: 9/21/16 DISBURSEMENT DATE:9/21/16
<br /> J::Summa".of:BU"erttrafisaotonir.:_1;:`ir
<br /> 400:"Gross'amount:iitreito-seller.'=i2:t. '.r;.'.'::' ": J.
<br /> 101.Contract sales price 233,000.00 401.Contract sales price 233,ODO.00
<br /> 102.Personal property 402.Personal property
<br /> 103.Settlement charges to buyer(Line 1400) 2,942.78 403.
<br /> 104• 404.
<br /> 105: 405.
<br /> Ad ustments'foi•.i ins' aids6 selieclii'aiiGaricei'.'�-i.:.':.c :' .. . ..:-, "'Ad ustments-forittems.`aitl'b'•salla'riri'advance::. .=
<br /> 106.Ci !town taxes 406.Cityltown taxes
<br /> 107.County taxes, 407.County taxes
<br /> 108.Assessments 408.Assessments
<br /> 109. 409.
<br /> 110, 410.
<br /> 111. 411.
<br /> 112, 412.
<br /> 120.Gross amount due ftom 235.942.78 420.Gross amount due to seller: 233,000.00
<br /> 300;Ain8trots. aidior,'.iriibaFialf:of:b_ ray:„:�;..::,:'.i5:,�;.'.:::_'::r': :'::,:X600::Reutidri§3':airio-''due�aaeler•.::::::::'::;:::r:=. ... .
<br /> 201.Depositor earnest money 501,Excess deposit(see Instructions)
<br /> 202.Prtndipal.amount of new loan(s) 502.Settlement charges to seller pine 1400) 1;500.00
<br /> 2113.Existing loan(s)taken subject to 503.Existing loan(s)taken subject to
<br /> 204.Principal amount of second mortgage 504,Payoff of first mortgage loan 121,32&51
<br /> 205- 505.Payoff of second mortgage loan
<br /> 206• 506.Deposits held b seller
<br /> 207.Principal amt of mortgage held by seller 607,Principal amt of mortgage held by seller
<br /> 208. 508•
<br /> 209. 509.
<br /> '"Adustitrehtsifdiltenfsiu'r5.' id•b'Belle%'E'.:'":>:C,::•,_,63,�-;:;:a.;a;. ;:,+::Adastm'ehisCforr.:itams.fin ald'6:isaller.��'i?wii�hs: ;;:..:::":f:.°.?,:
<br /> 210.Cityltown taxes 510.City/town taxes
<br /> 211.County taxes from 01/01/16 to 09/21/16 1,508.76 511.County taxes from 01/01/16 to 09/21/16 1,508.76
<br /> 212,Assessments 512.Assessments
<br /> 213. 513.
<br /> 214. 514.
<br /> 215. 5i5.
<br /> 216. 516.
<br /> 217. 517.
<br /> 218, 518.
<br /> 219. 519.
<br /> 220.Total paid by/for buyer. 1,508.76 520.Total reductions In amount due seller: 124,337.27
<br />� 30 :hC"sn a:s e..ehkYfofrilto'rliii _Pc�:>.e•<.��-:; ::�;;,::••:'•;:;=.:,;r•• ;60Qi'Cash:3tsetttem"d;td 'rii�'a te'r.^:';;-�:;-,::±;::..�:
<br /> 301.Gross amount due from buyer 235,942.78 601.Gross amount due to seller 233,000.00
<br /> pine 120) pine 420)
<br /> 302.Less amount paid bylfor the buyer (1,508.76) 602.Less total reductions In amount due seller (124,337.27)
<br /> (line 220) (line 520)
<br /> r30-3'C'-sh( Q✓ From Q To )Buyer: 234,434.02 603.Cash([]✓ To ❑From )Seller. 108,682.73
<br /> Substitute Form 1099 Salter Statement: The information contained in blocks E,G,H,and I and on line 4Q1 Is Important tax Information and is being
<br /> fumished to the IRS. Ifyou are required to file a return,a negligence penalty or other sanction will be imposed on you If this Rem is required to be reported and
<br /> the IRS determines that It has not been reported.
<br /> Seller Instructions: If this real estate was your principal residence,file Form 2119,Sale or Exchange of Principal Residence,for any gain,with your tax
<br /> return;for other transactions,complete the applicable parts of Form 4797,Form 6262 and/or Schedule'D(Form 1040).
<br /> Double'nmeS
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