HomeMy WebLinkAbout2007 Affidavit of No Lien Disbursement and ComplianceAFFIDAVIT OF NO LIEN DISBURSEMENT AND COMPLIANCE
AND CERTIFICATION OF NON - FOREIGN STATUS
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
BEFORE ME, the undersigned notary public, personally appeared Bettina Boudrot,
an unmarried woman, who, having been first duly sworn according to law, deposes and
says:
Affiant has personal knowledge of all matters set forth in the Affidavit.
2. Affiant (hereinafter referred to as the "Owner ") holds fee simple title to certain real
Property (hereinafter referred to as the "Property ") situate in Indian River County, Florida,
and more particularly described in Exhibit "A" attached hereto to this Affidavit and by this
reference made a part of this Affidavit.
3. The Owner has been vested with title to the Property since September 10, 1992. For
purposes of the 1099 IRS report, Affiant certifies that the Property is x is not the
current homestead of the Owner.
4. The Owner's title to and possession and enjoyment of the Property has been open,
notorious, peaceable and undisturbed.
5. Neither the Owner's title to nor possession of the Property has ever been disputed or
questioned nor is the Owner aware of any facts by reason of which the title to, or possession
of, the Property or any part of it or any personal property located on it might be disputed or
questioned or by reason of which may claim to the Property or any portion of it or any
personal Property located on it might be adversely asserted.
6. No person or entity other than the Owner claims or is presently entitled to the right to
possession or is in possession of the Property other than the Owner.
7. There are no disputes concerning the location of the boundary lines of the Property.
8. There are no easements affecting the Property not disclosed by the public records.
9. There are no security agreements, financing statements, title retention contracts or
personal property leases affecting any materials, fixtures, appliances, furnishings or
equipment placed on it or installed on the Property or the improvements located on it.
10. There are no actions, proceedings, judgments, bankruptcies, liens or executions
recorded or pending among the Public Records of Indian River County, Florida, or any other
county in Florida against the Owner. No judgments or decrees have been entered in any
court of this State or the United States against the Owner which remain unsatisfied. That the
Property is not encumbered by the lien of any decree, judgment, writ or attachment or tax
lien.
11. There are no mechanic's materialmen's or laborer's liens or construction liens under
Chapter 713 of the Florida Statutes filed against the Property, no improvements or repairs
have been made to the Property during the ninety -day period immediately preceding the date
of this Affidavit, there are no unpaid bills of any nature, either for labor or materials used in
the making improvements or repairs on the Property, or for services of architects, surveyors
or engineers incurred in connection with the Property and that no person, firm or corporation
is entitled to a lien under Chapter 713 of the Florida Statutes, except for the following:
NONE
12. The Owner has made no additional improvements to the real Property and has
received no Notice of proposed back assessments from the Appraiser's Office or bill for back
assessments from the Tax Collector.
13. The Owner has not received notice of utility, paving, water, special, impact,
development, waste or sewer assessments or any public hearing regarding future or pending
assessments to improvements by any governmental instrumentality, which are now unpaid,
against the Property.
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14. Seller certifies that since December 5, 2006, the date of the last title certification, no
lien, encumbrance, or other document has been filed of record, which adversely affects title
to the Property.
15. Owner hereby agrees and represents that Owner will not execute any instrument, or
do any act whatsoever, that in any way would or may affect the title to the Property, including
but not limited to the mortgaging or conveying of the Property or any interest in it or causing
any liens to be recorded against the Property or the Owner between the earlier of (1) the
date of this affidavit or (2) the disbursing of funds and the recording of the Deed conveying
the subject Property.
16. The personal property contained in the buildings on said premises, and which, if any,
is being sold to the Purchaser(s) mentioned below, is also free and clear of all liens,
encumbrances, claims and demands whatsoever.
17. Owner, in the operation of said building and Property, complied in all respects with
the Sales Tax Law of the State of Florida.
18. Owner knows of no violations of Federal, State, County or Municipal Ordinances or
Rules and Regulations, Law or Statutes of any governmental authority having jurisdiction
with respect to the Property, or Environmental Protection Laws nor is Owner aware of any
hazardous waste contamination affecting the Property or on any adjacent land that my give
rise to an action or to a liability under any law, risk, statute, ordinance or common law theory.
19. In the event the real estate tax proration is based on a real estate tax bill from a
previous year, Owner agrees to adust the real estate tax proration based on the real estate
tax bill for the current year. If the current real estate and personal property taxes vary
materially in amount from the figures used in making the prorations in closing the transfer
and conveyance of the Property to the Buyer /Borrower then a new proration and a correct
and proper adjustment will be made upon demand. except Seller shall not be responsible
for property tax increases due to a change in ownership.
20. In the event any documents which adversely affect title to the Property are filed of
record subsequent to the date and time set forth above through the date and time of
recording title to the Buyer and /or recording of any mortgages, Owner agrees to assume full
legal responsibility for satisfaction and /or removal of such instruments.
21. Owner agrees to indemnify Hatch & Doty, P.A., ( "H &D ") and Underwriter issuing title
insurance for any loss or damage, including court costs and attorney /paralegal fees arising
from any intervening liens or other matters which adversely affect the title to the Property or
first lien position of any insured lender.
22. Owner understands that the figures set forth on the Closing Statement relating to
mortgage payoffs, taxes, utilities, rental adjustments, maintenance fees, special
assessments and /or any other charges are based on the best information available at time
of closing. Except as provided for herein, in the event that any charge or credit differs from
the actual figure(s), the party so charged or credited will promptly pay all additional sums
owing to correct the discrepancy. Occasionally there is a shortage or overage in the trust
account maintained for you by H &D. This is usually due to an actual charge for an item
being more or less than reflected on the closing statement. If an overage is more than Ten
Dollars, H &D will refund the overage to the appropriate party. If an overage is Ten Dollars
or less, H &D will retain the overage. If a shortage is less than Ten Dollars, H &D will be
responsible for the shortage. If a shortage is Ten Dollars or more, the appropriate party will
be responsible for the amount of the shortage
23. CERTIFICATION OF NON - FOREIGN STATUS UNDER PENALTIES OF
PERJURY, the undersigned state that:
Check those that a
NON - FOREIGN STATUS:
X Owner is /are not a foreign person(s), a foreign corporation, foreigh partnership,
foreign trust, or foreign estate (as those forms are defined in the Internal Revenue
Code and Income Tax Regulations); and
Owner is not a disregarded entity as defined in 26 CFR §1.1445- 2(b)(2)(iii);
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Owner's U.S. Taxpayer Identification Number is 031 -36 -1599
Her full name appears at the bottom of this instrument
Her home address is 1306 12th St. #B, Vero Beach, FL 32960.
FOREIGN STATUS:
❑ Owner(s) is /are a foreign person, foreign corporatin, foreign partnership, foreign trust
or foreign estate (as those terms are defined in the Internal Revenue Code and
Income Tax Regulations);
❑ Owner(s) is /are a disregarded entity as defined in 26 CFR §1.1445(b)(2)(iii)., then
Owner's TIN or EIN Number is:
Each Owner(s) U.S. TIN or EIN is:
Owner(s) home or business address is:
Under penalties of perjury I declare that I have examined the above certification of
non foreign status and to the best of my knowledge and belief it is true, correct and
complete, and I further declare that I have authority to sign this document on behalf
of the Owner(s).
Owner(s) understand that this certification may be disclosed to the Internal Revenue
Service by transferee and that any false statement contained herein could be
punished by fine, imprisonment, or both.
25. This Affidavit is made to induce City of Sebastian to purchase the Property from
Owner and to induce Hatch & Doty, P.A., through its Underwriter to issue a policy to insure
the title to the Property. Owner shall hold Hatch & Doty, P.A., and its underwriter harmless
for any and all loss, penalty, interest, legal fee or other costs incurred as a result of any false
statement or inaccuracy herein or any unrecorded claims, mechanics liens or encumbrances
against the Property.
26. Owner has executed this Affidavit for the purpose of inducing Hatch & Doty, P.A., to
disburse at the time of closing, any proceeds of sale, any mortgage proceeds and /or
disbursements made in accordance with the Closing Statement signed by Owner and to
Induce the Underwriter issuing the title insurance policy to insure the title through the date
of recording
27. The Owner acknowledges the receipt of two Privacy Notices. One from the underwriter
issuing the title insurance policy in this transaction and one from Hatch & Doty, P.A. Owner
has been informed that if Owner would like to limit Hatch & Doty PA's disclosures of personal
information about Owner, then Owner should follow the opt out instructions contained in H
& D's, Privacy Notice.
28. Owner further states that Owner is familiar with the nature of an oath; and with the
penalties as provided by the laws of the State aforesaid for falsely swearing to statements
made in an instrument of this nature. Owner further certify that Owner has read or has heard
read to Owner, the full facts of this Affidavit, and understand(s) its context.
Bettina Boudrot
Sworn to and subscribed before me this 9 day of Jz°A °Y 2007by Bettina Boudrot
NOTARY PUBLIC
Personally known ✓ OR Produced Identification Type of Identification Produced:
Driver License(s)
Boudrot.Aff �;�rP�B,, Frances Ann Nelson
Commission #DD289813
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Expires: Mar 12, 2008
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, I Atlantic Bonding Co., 1W.
Exhibit "A"
PARCEL 1:
Lots 3 and 4, less the North 42 feet of Lot 4, Block 3, HARDEES SUBDIVISION B, according to the Plat thereof
as recorded in Plat Book 4, page 74, Public Records of St. Lucie County, Florida; now lying and being in Indian
River County, Florida, and less and except those portions conveyed to the City of Sebastian in O.R. Book 936,
page 2133 and O.R. Book 1946, page 766, Public Records of Indian River County, Florida.
•dG014ift
The South 5 feet of the North 7.2 feet of Lot 2, Block 3, HARDEES SUBDIVISION B, according to the Plat thereof
as recorded in Plat Book 4, page 74, Public Records of St. Lucie County, Florida, said land now lying and being in
Indian River County, Florida..
AND
The South 30 feet of the North 65 feet of Lot 2, Block 3, HARDEES SUBDIVISION B, according to the Plat thereof
as recorded in Plat Book 4, page 74, Public Records of St. Lucie County, Florida; said land now lying and being in
Indian River County, Florida.
AND
The North 35 feet of Lot 2, Block 3, HARDEES SUBDIVISION B, according to the Plat thereof as recorded in Plat
Book 4, page 74, Public Records of St. Lucie County, Florida; said land now lying and being in Indian River
County, Florida.
I_PJ:§
A parcel of land being the North 2.00 feet of the South 23.5 feet of Lot 2, Block 3, HARDEES SUBDIVISION B,
according to the Plat thereof as recorded in Plat Book 4, page 74, Public Records of St. Lucie County, Florida;
said land now lying and being in Indian River County, Florida, being more particularly described as follows:
Beginning at the intersection of the East right of way line of Indian River Drive (60 foot right of way) and the North
line of the South 23.5 feet of Lot 2, proceed South 87 °36'23" East along said North line a distance of 47.69 feet to
a point on the safe upland line (S.U.L.) on the West bank of the Indian River (S.U.L. elevation 0.9 N.C.V.D.,
located on 7/12/88); thence South 11'52'05" East along the S.U.L. a distance of 2.06 feet to a point being 2.00
feet South of the North line of the South 23.5 feet of Lot 2 when measured perpendicular; thence North 87 °36'23"
West along a line 2.00 feet South of and parallel to said North line of the South 23.5 feet of Lot 2 a distance of
68.10 feet to a point on the East right of way line of Indian River Drive; thence North 00 °26'42" West along said
East right of way line a distance of 2.00 feet to the Point of Beginning.