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2020-128
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Last modified
3/4/2021 2:45:31 PM
Creation date
7/20/2020 4:09:02 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
07/14/2020
Control Number
2020-128
Agenda Item Number
8.F.
Entity Name
Dawsey, Woodrow & Belinda
Subject
Agreement to Purchase and Sell Real Estate with lease agreement
Added: Copy of closng agreement and settlement and settlement
Warranty Deed; Owner's Pollicy of Title Insurance;
Area
58th Avenue Improvements
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13. Seller understands that Section 1445 of the Internal Revenue Code provides that a Buyer of a United States <br />real property interest must withhold tax if the Seller is a foreign person. To inform the Buyer that withholding <br />of tax is not required upon purchase of the above described property, Seller certifies the following: <br />Seller is not a nonresident alien individual, foreign corporation, foreign partnership, foreign trust or <br />foreign estate for purposes of United States federal income taxation. <br />Seller's U.S. Taxpayer Identification Number is. <br />Seller's address is: 5800 37th Street, Vero Beach, FL 32966. <br />No other persons or entities have an ownership interest in the above described property. <br />14. Seller understands the Buyer of the described property intends to rely on the foregoing representations in <br />connection with the United States Foreign Investment in Real Property Tax Act. (FIRPTA). Seller understands <br />this certification may be disclosed to the Internal Revenue Service by the Buyer and that any false statements <br />contained in this certification may be punished by fine, imprisonment or both. Seller has the authority to sign <br />this affidavit as either individual Seller or on behalf of an entity Seller. Under penalties of perjury, Seller states <br />that this declaration was carefully read and is true and correct. <br />15. This affidavit is given for the purpose of clearing any possible question or objection to the title to the above <br />referenced property and, for the purpose of inducing Atlantic Coastal Land Title Company, LLC and <br />Westcor Land Title Insurance Company to issue title insurance on the subject property, with the knowledge <br />that said title companies are relying upon the statements set forth herein. Seller hereby holds Atlantic Coastal <br />Land Title Company, LLC and Westcor Land Title Insurance Company harmless and fully indemnifies <br />same (including but not limited to attorneys' fees, whether suit be brought or not, and at trial and all appellate <br />levels, and court costs and other litigation expenses) with respect to the matters set forth herein. "Affiant", <br />"Seller" and "Buyer" include singular or plural as context so requires or admits. Seller further states that he/she <br />is familiar with the nature of an oath and with the penalties as provided by the laws of the United States and <br />the State of Florida for falsely swearing to statements made in an instrument of this nature. Seller further <br />certifies that he/she has read, or heard read, the full facts of this Affidavit and understands its context. <br />Under penalties of perjury, I declare that I have read the foregoing Affidavit and that the facts stated in it are true. <br />ow Dawsey <br />STATE OF FLORIDA <br />COUNTY OF INDIAN RIVER <br />The foregoing instrument was acknowledged before me by means of () physical presence or () online notarization this 11 th day of <br />August, 2020, by Woodrow Dawsey. <br />Signat4re,dlqotary Public <br />Print, ype/Stamp Name of Notary <br />Personally Known: OR Produced Identification: <br />Type of Identification n <br />Produced: nU-� <br />a'9ir o" •, JASON A. BEAL <br />?° • Notary public -State of Florida <br />Commission # HH 012213 <br />? of n My Comm. Expires Oct 11, 2024 <br />Bonded through National Notary Assn. <br />Closing Affidavit — Seller <br />File No.: 2020-5321 Page 2 of 2 <br />
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