Laserfiche WebLink
s <br /> 4 <br /> FDOR10240300 <br /> FLORIDA DEPARTMENT OF REVENUEVOFI <br /> DR-219 <br /> RETURN FOR TRANSFERS OF INTEREST IN REAL PROPERTY i R.07/98 <br /> (PLEASE READ INSTRUCTIONS BEFORE COMPLETING) MET <br /> Enter numbers as shown below. If typing,enter numbers as shown below. <br /> 1. Parcel Identification Number 0 1 2 3 4 5 6 1 $ 9 0123456789 <br /> (If Parcel ID not available <br /> please call County Property <br /> Appraiser's Office) --* <br /> Transaction is a split Property was improved <br /> 2. Mark(x)all Multi-parcel or cutout from with building(s)at time <br /> that apply transaction? –4 another parcel? of sale/transfer? —► <br /> 3. Grantor(Seller): LOST TREE VILLAGE CORPORATION <br /> Last First MI Corporate Name(if applicable) <br /> 3399 PGA BLVD. #260 PALM BCH GDNS FL 33410 C ) <br /> Mailing Address City State Zip Code Phone No. <br /> INDIAN RIVER COUNTY, ET AL. <br /> 4. Grantee(Buyer): <br /> Last First MI Corporate Name('rf applicable) <br /> 1840 25TH STREET VERO BEACH FL 32960 ( ) <br /> Mailing Address City State Zip Code Phone No. <br /> S. Date of Sale/Transfer Sale/Transfer Price <br /> 2 5 2003 $ $100 0 Property 41 County Code <br /> ■ Located In <br /> Month Day Year (Round to the nearest dollar.) <br /> 6. Type of Document Contract/Agreement Other T. Are any mortgages on the property? If"Yes", YES X NO <br /> for Deed outstanding mortgage balance: <br /> Warranty Quit Claim $ <br /> Deed X (Round to the nearest dollar.} 00 <br /> Deed <br /> 8. To the best of your knowledge,were there unusual circumstances or conditions to the sale/transfer <br /> such as:Forced sale by court order?Foreclosure pending?Distress Sale?Title defects?Corrective Deed?Mineral rights? <br /> Sale of a partial or undivided interest?Related to seller by blood or marriage. YES NO <br /> 9. Was the sale/transfer financed? YES NO If"Yes",please indicate type or types of financing: <br /> Agreement or <br /> Conventional Seller Provided Contract for Deed Other <br /> Institutional/ <br /> 10. Property Type: Residential Commercial Industrial Agricultural Miscellaneous Government Vacant Acreage Timeshare <br /> Mark(x)all X <br /> that apply <br /> Cents <br /> 11. To the best of your knowledge,was personal property YES x NO $ C <br /> included in the sale/transfer?If"Yes",please state the • <br /> 00 <br /> amount attributable to the personal property.(Round to the nearest dollar.) $ 0.00 <br /> 12. Amount of Documentary Stamp Tax —� <br /> 13. if no tax is due in number 12,is deed exempt from Documentary Stamp Tax under s.201.02(6),Florida Statutes? YES NO <br /> Under penalties of perjury,I declare that I have read the foregoing return and that the facts stated in it are true.If prepared by someone other <br /> Lthan the taxpayer,his/her declaration is based on all information of which he/her has any knowledge. <br /> Signature of Grantor or Grantee or Agent Date <br /> WARNING:FAILURE TO FILE THIS RETURN OR ALTERNATIVE FORM APPROVED BY THE DEPARTMENT OF REVENUE SHALL RESULT IN A PENALTY OF$25.00 IN ADDITION TO ANY <br /> OTHER PENALTY IMPOSED BY THE REVENUE LAW OF FLORIDA_ <br /> To be completed by the Clerk of the Circuit Court's Office Clerks Date Stamp <br /> This copy to Department of Revenue <br /> O. R. Book 1]W 1:1111 <br /> and <br /> Page Number � <br /> and <br /> File Number [ O❑000, T1 <br /> I!� <br /> Date Recorded Ll u / IJ LJ / L__1 I_!`:_ L <br /> Month Day Year <br /> This copy to Department of Revenue <br />