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344 Each person signing this Contract on behalf of a party that is a business entity represents and warrants to the other <br />345 party that such signatory has full power and authority to enter into and perform this Contract in accordance with its <br />346 terms and each person executing this Contract and other documents on behalf of such party has been duly authorized <br />347 to do so. <br />348 ATTENTION: SELLER AND BUYER <br />349 CONVEYANCES TO FOREIGN BUYERS: Part III of Chapter 692, Sections 692.201 - 692.205, Florida Statutes, 2023 <br />350 (the "Act"), in part, limits and regulates the sale, purchase and ownership of certain Florida properties by certain buyers <br />351 who are associated with a "foreign country of concern", namely: the People's Republic of China, the Russian <br />352 Federation, the Islamic Republic of Iran, the Democratic People's Republic of Korea, the Republic of Cuba, the <br />353 Venezuelan regime of Nicol6s Maduro, or the Syrian Arab Republic. It is a crime to buy or knowingly sell property <br />354 in violation of the Act. <br />355 At time of purchase, Buyer must pro"—a-si'6 Yc4Affidavit which complies with the requirements of the Act. <br />356 Seller and Buyer re ad d to seek egak-Gounsik n i�arding their respective obligations and liabilities under the Act. <br />u <br />--,� b. <br />357 l/W'L : " ` Date: npc pmhPY A 9(l9 5 <br />(Signature of Buyer `: x <br />35a Deryl Loar Fv,> y°:'j Tax ID No.: 59-6000674 <br />(Typed or Printed Name of Buyer) ..•.-.. • <br />AttesY:'Ryan L. Butler, Clerk of <br />359 Title: Chairman Circuit Court anri_C.,m n r fli&Phone: 772-226-1441 <br />360Date: 2-1 <br />i, 4 <br />gnatur /nof Buyer By:4/-Y <br />ji '1 do . �l bi� ` , eputy Clerk <br />4 <br />361 r Tax ID No.: C) I C <br />(Typed or Printed Name of Buyer) <br />362 Title: �� %G/'!fM 1/0, */S Telephone: APPROVED AS TO FORM <br />363 Buyer's Address for purpose of notice <br />364 <br />Facsimile: <br />Email: <br />H1ST <br />CPHER A. HICKS <br />365 <br />Date: <br />u A <br />(Sig ture of S le ) <br />366 <br />s eq 7: �. riAC fir, : Ayi <br />E_ Aff-- 1 -i -rax ID No.: <br />(Typed or Prin ed Name of Seller) <br />367 <br />Title: V °�� F a <br />Telephone: <br />368 <br />( �� <br />Date: 1 0)l <br />to <br />(Signature of S Iter) <br />369 <br />t�1r� r�:r � A -AC> <br />Tax ID No.: <br />(Typed or Printed Name of Seller) <br />370 <br />Title: AJV. <br />C -,j 4 O N>b N Telephone: <br />371 <br />Seller's Address for purpose of notice: <br />372 <br />Facsimile: <br />Email: <br />Florida REALTORS' makes no representation as to the legal validity or adequacy of any provision of this form in any specific transaction. This <br />standardized form should not be used in complex transactions or with extensive riders or additions. This form is available for use by the entire real <br />estate industry and is not intended to identify the user as REALTOR'. REALTOR' is a registered collective membership mark which may be used <br />only by real estate licensees who are members of the NATIONAL ASSOCIATION OF REALTORS'and who subscribe to its Code of Ethics. The <br />copyright I ws of United States (17 U.S. Code) forbid the unauthorized reproduction of this form by any means including facsimile or computerized <br />forms. <br />Buyer ( )I�- and Seller ( ) ( acknowledge receipt of a copy of this page, which is Page 8 of 8 Pages. <br />CC -6 Rev. 3/25 02025 Florida Realtors® <br />Serial#:098848-600175-9764505 ' Form <br />Simplicity <br />