Quit Claim Deed Flori

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					                                                                FLORIDA DEPARTMENT OF REVENUE
                                                          RETURN FOR TRANSFERS OF INTEREST IN REAL PROPERTY

                                                               (
                                                                   -(PLEASE READ INSTRUCTIONS BEFORE-
                                                                      -- -- -   -   -  -- - -     -
                                                                                                    COMPLETING)
                                                                                                             --

                                                                   Use black ink. Enter numbers as shown below.                If typing, enter numbers as shown below.
                                                                                                                                                                          ?NET
1.    Parcel ldentlflcation Numbel
      (If Parcel ID not available
                                                              i mmnmm~n~mo~ A F ~ T F I L I ~
                                                                         E            I
      please call County Property
      Appraiser's Office) -)
                                                                                                                           -
      Mark (x) all
      that apply
                                Multi-parcel
                                transaction?                  -)
                                                                     -
                                                                     L~
                                                                                                  Transaction is a split
                                                                                                  or cutout from
                                                                                                  another parcel?   ' IX1
                                                                                                                                                               Property was improved
                                                                                                                                                               with building@)at time
                                                                                                                                                               of s a e ~ r a n s e  +      11
                                                                                                                                                              Pasco County
3. Grantor (Seller):
                             Last                                                    First                         MI                           Corporate Name (if applicable)
                 37918 Meridian Ave,                                                                Dade City                       FL                        33525          (     )
                                     Mailing Address                                                     City                       State                     Zip Code       Phone No.
                                                                                                                               Florida Department of Transportation
4.    Grantee (Buyer):
                             Last                                                    First                         MI                           Corporate Name (if applicable)
            11201 Malcolm McKinley Dr                                                                   Tampa                       FL                        33612          (     )
                          Mailing Address                                                               City                        State                     Zip Code       Phone No.
5.    Date of Salerrransfer                                                                     Salerrransfer Price


         Month              Day                                    Year
                                                                                                                                            .                      Property
                                                                                                                                                                   Located In   Pasco

6,    T~~~of D~~~~~~~
                                    u
                                    m :;:;
                                     ia
                                                  ConttncffAgreement
                                                  for Deed
                                                                               j-1
                                                                               1)(1
                                                                                        Other         7. Are any mortgages on the property? If "Yes",
                                                                                                         outstanding mortgage balance:
                                                                                                 (Round to the nearest dollar.)     $
                                                                                                                                      -- . _ -

                                                                                                                                        -    ~   -   .
                                                                                                                                                               ,    ~;
                                                                                                                                                                                   YES
                                                                                                                                                                          .-~, r-- ~. r--
                                                                                                                                                                      I I I 1s- ~I i I .
                                                                                                                                                                                        ,
                                                                                                                                                                                                 /
                                                                                                                                                                                                 .o 0:
                                                                                                                                                                                                      :%:NO



8.    To the best of your knowledge, were there unusual circumstances or conditions to the saleltransfer
      such as: Forced sale by court order? Foreclosure pending? Distress Sale? Title defects? Corrective Deed? Mineral rights?
      Sale of a partial or undivided interest? Related to seller by blood or marriage.                                                                                             YES    I ] / Yi         NO

9. Was the salenransfer financed?                             YES          /         --NO       If "Yes", please indicate type or types of tinancing:

                                                                                                                           /I]
                                    -.

           Conventional
                                    I


                                        -
                                              ,


                                              :               Seller Provided         Ij            Agreement or
                                                                                                    Contract for Deed                       Other        /1
                                                                                                                   Institutional1
10. Property Type:              Residential                    Commercial        Industrial       Agricultural     Miscellaneous        Government                  Vacant      Acreage        Timeshare
                                              -.
    Mark (xj ail
    that apply                               b
                                            Ic
                                            L_    ~                                                   -
                                                                                                                                                                             ----                      Cents-
                                                                                                           1 ! / % ' NO                                                                               -



                                                                                                                            - 01 r:l~
                                                                                                                               ~r-1
11. To the best of your knowledge, was personal property          YES .. .
    included in the saleltransfer? If 'Yes". i lease state the
                                                                                                            ~




    amount attributable to the personal p;operty. (Round to the nearest dollar.)
12. Amount of Documentary Stamp Tax                                                                                                 S                                             10 1 . :.7 i -i
                                                                                                                                                                                         ~--'
                                                                                                                                                                                          -7      ~
                                                                                                                                                                                                      ,
                                                                                                                                                                                                      L
                                                                                                                                                                                                      r
                                                                                                                                                                                                                I


13. If                                                             Stamp Tax under s. 201.02(6), Florida Statutes?
                 is due in number 12, is deed exempt from Documenta~                                                                                                               YES/X~        /        NO
           Under penalties of perjur\/. I declare that I
                                                    s
           than the taxpayer, hls.'hcr declaration 1 b
           Signature of         ranio or or Gr-antccor Agent
           ..,
           v.+,L(!~ll:.iG ?&I' x q k         O
                                            T -,I       V F i .)HI.. j K A
                                                                      C
           57;!r:f?bE.J*l     ,
                             1f it,:,>:>:;:     1 nv TL+L k?r..:: ;\,,I: , l : ~ [ !;:<,!>;>, : ,
                                                 2                             :
                                                                           , , . ' ; ~


           To be completed by the Clerk of the Circuit Court's Office                                                                                          Clerks Date Stamp

           This copy to Property Appraiser


     0 . R. Book
         and
                                                          ,
                                                          -
         and


Date Recorded                 a
                              Month
                                                      /   1,   Day
                                                                   n/ /-I ~7
                                                                           1'---       Year
                                                                               This copy to Property Appraiser
     111 11 I
                                                                                                                                                                   FDORIM40300
                                                FLORIDA DEPARTMENT OF REVENUE
                                                                                                                                                  NET
                                                                                                                                                                        DR-219
                                            RETURN FOR TRANSFERS OF INTEREST IN REAL PROPERTY
                                                   (PLEASE READ INSTRUCTIONS BEFORE COMPLETING)                                                                          R. 07/98


1.    Parcel Identification Number
      (If Parcel ID not available
      please call County Property
                                                  Enter numbers as shown below.
                                                      0 1 2 3 4 5 6 7 8 9
                                                                                     If typing, enter numbers as shown below
                                                                                                                          0123456789                                   r
      Appraiser's Office) -)
                                                                               Transaction is a split                              Property was improved
2.    Mark (x) all            Multi-parcel
      that apply              transaction?     '                               or cutout from
                                                                               another arce el?  '%                                with building(s) at time
                                                                                                                                   of sale/transfef?           '
                                                                                                                                  Pasco County
3.    Grantor (Seller):
                          Last                                   First                          MI                        Corporate Name (if applicable)
                37918 Meridian Ave,                                               Dade City                          FL          33525            ,
                                                                                                                                                  \
                                                                                                                                                           \
                                                                                                                                                           I
                                Mailing Address                                        City                      State          Zip Code          Phone No.
                                                                                                          Florida Department of Transportation
4.    Grantee (Buyer):
                          Last                                   First                          MI                        Corporate Name (if applicable)
           11201 Malcolm McKinley Dr                                                 Tampa                           FL           33612           ,
                                                                                                                                                  \
                                                                                                                                                           1
                                                                                                                                                           I
                          Mailing Address                                             City                       State          Zip Code          Phone No.
5.    Date of Salerrransfer                                                   Salerrransfer Price
                                                                $                                                                   Property          61       County Code
          1               22                   2008                                                                       00        Located In
        Month             Day                     Year                   (Round to the nearest dollar.)

6. T~~~of D~~~~~~~                       ContracVAgreement )( Other                7. Are any mortgages on the property? If "Yes",                         YES                 NO
                                         for Deed                                     outstanding mortgage balance:
            Warranty
            Deed
                                         Quit Claim
                                         Deed
                                                                              (Round to the nearest dollar.)     $                                                    .OO
8.    To the best of your knowledge, were there unusual circumstances or conditions to the saleltransfer
      such as: Forced sale by court order? Foreclosure pending? Distress Sale? Title defects? Corrective Deed? Mineral rights?
      Sale of a partial or undivided interest? Related to seller by blood or maniage.                                                                      YES                 NO

9.    Was the salehransfer financed?           YES                   NO If "Yes", please indicate type or types of financing:
                                                                                 Agreement or
           Conventional                       Seller Provided                    Contract for Deed                    Other
                                                                                                Institutionall
10. PropertyType:             Residential      Commercial       Industrial      Agricultural    Miscellaneous        Government          Vacant       Acreage      Timeshare
    Mark (x) all
    that apply                       %                                                                                    %               %
                                                                                                                                                                         Cents
1 . To the best of your knowledge, was personal property
 1
    included in the saleltransfel? If "Yes", please state the
                                                                  YES
    amount attributable to the personal property. (Round to the nearest dollar.)
                                                                                                    %NO          $
                                                                                                                                                                      moo
                                                                                                                                          0.00
12. Amount of Documentaly Stamp Tax

13. If no is due in number 12, is deed exempt from Documentary Stamp Tax under s. 201.02(6), Florida Statutes?                                             YES                 NO
           Under penalties of perjury. I declare that I                                                                         ~t are   truc If prepared by someone other
           than the taxpayer, histher declaration is b
           Signature of Grantor or. Grantee or Agent
                                           FILE WlS RETURN OR ALT
           \.:&RI~IIl,iG F A I I ~ U R E I O
           3TI~ltR    PENkLTf IMFOSED 0 'THE REi'ENUE LAIPJ OF FLORI!lA
                                                1

           To be completed by the Clerk of the Circuit Court's Office                                                                      Clerks Date Stamp

                       This copy to Department of Revenue


     0. R. Book           1
        and                      .   .




         and


Date Recorded
                          Month                 Day                 Year
                                                                This copy to Department of Revenue

				
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