AffidavitAFFIDAVIT
STATE OF FLORIDA
COUNTY OF BROWARD
DATE OF CLOSING: APRIL 14, 1994
BEFORE ME, the undersigned authority, personally appeared Gil
Hyatt, President of MANGIL, INC., a Florida corporation,
Affiant(s) who after being deposed, on oath and said:
1. That MANGIL, INC., a Florida corporation is the owner(s)
of the following described property, to wit:
LOTS 31 AND 32, BLOCK 2, HIBISCUS PARR, ACCORDING TO THE PLAT
THEREOF RECORDED IN PLAT BOOK 3, PAGE 166, PUBLIC RECORDS OF MONROE
COUNTY, FLORIDA
AND
LOTS 15 THROUGH 21 INCLUSIVE, BLOCK 4, INDUSTRIAL ACRES, ACCORDING
TO THE PLAT THEREOF, RECORDEDIN PLAT BOOK 5, PAGE 15, PUBLIC RECORDS
OF MONROE COUNTY, FLORIDA
2. ( ) Said property is the principal residence of the
Affiant(s); or
( ) Affiant(s) presently reside at:
and
the said property is not the homestead of Affiant(s).
( X ) The said property is not occupied by tenants or
any other parties except as follows:
None
3. That the above described property is free and clear of
all liens, taxes, encumbrances and claims of every kind, nature and
description whatsoever, except for the mortgage(s), if any,
described below, and except for real estate and personal property
taxes for the year 1994.
4. That there have been no improvements, alterations, or
repairs to the above -described property for which the costs thereof
remain unpaid, and that there are no claims for labor or material
furnished for repairing or improving the same, which remain unpaid,
except the following:
None
5. That there are no mechanic's, materialmen's or laborer's
liens against the above -described property.
6. That the personal property contained in the buildings on
said property, or on the 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.
7. The Affiant(s), in the operation of said building and
property, complied in all respects with the Sales Tax Law of the
State of Florida.
8. The Affiant(s), know of no violation of county or
municipal ordinances pertaining to the above -described prpoerty.
9. ( X ) That this Affidavit is made for the purpose of
inducing MONROE COUNTY BOARD OF COUNTY COMMISSIONERS to purchase
said property from Affiant(s), for a gross sales price of
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$350,000.00.
( X ) That this Affidavit is also made for the
purpose of inducing LAWYERS LAND TITLE CO. to issue a policy of
title insurance on said property.
( ) That this Affidavit is also made for the purpose of
inducing *** to loan money to Affiant(s) and to take back a
mortgage in the amount of $*** to secure payment of said amount.
10. That no judgment or decree has been entered in any court
of the State of the United States against said Affiant(s), and
which remains unsatisfied, and that Affiant(s) has no present plan
to file proceedings against him/her under the bankruptcy laws, nor
are there any other claims of any kind filed or fielable that would
adversely affect the title to the subject real estate.
11. Subsequent to April 4, 1994, Affiant(s) has/have not and
hereby agree(s) and represent(s) that Affiant(s) will not execute
any instrument or do any act whatsoever that in any way would or
may affect the title to the prpoerty, including but not limited to
the mortgaging or conveying of the proprty or any interest therein,
or causing any liens to be recorded against the property of
Affiant(s).
12. That none of the restrictions, agreements, covenants,
easements, declarations or other matters affecting title to the
property have been violated or encroached upon as of the date of
this Affidavit.
13. ( ) Affiant(s) is/are not a non-resident alien(s) for
purposes of U.S. Income Taxation, nor a foreign corporation,
foreign partnership, foreign trust or foreign estate (as those
terms are defined in the Internal Revenue Code and Income Tax
Regulations).
14. Affiant(s) Social Security Number of U.S. Employer
Identification Number is/are:
Mangil, Inc. Applied for
Name Number
15. Affiant(s) home address, or if an entity, the business
address is:
989 N.E. 45th Street, Fort Lauderdale, Florida 33334
16. Affiant(s) understand(s) that this certification may be
disclosed to the Internal Revenue Service by the transferee and
that any false statement contained herein could be punished by
fine, imprisonment or both.
17. Section 6045 of the Internal Revenue Code, as amended by
the Tax Reform Act of 1986, requires the reporting of certain
information on every real estate transaction. From the information
you provide below, a Form 1099-B will be produced, a copy of it
will be furnished to the IRS and to you no later than January 31st
of the next year, and a copy may be sent to other third parties.
If you fail to furnish adequate information (in particular, a
taxpayer ID number), then you will be subject to all IRS
Regulations, including the possible withholding of twenty (20%)
percent of the current sales price.
As to paragraphs 2, 9 and 13, only those portions marked by an
"X" are applicable.
Under penalties of perjury, I/we declare that I/we have
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examined this certification and to the best of my/our knowledge and
belief it is true, correct, and complete, and I/we further declare
that I/we understand that the taxpayer number above, will appear on
a Form 1099-B that will be sent to me/us and the Internal Revenue
Service.
MANGIL, INC.,
a F1orijda corporation
By
Gil Hy,?tt, President'
The foregoing instrument was acknowledge before me this
day of April, 1994, by Gil Hyatt, Pr esiden of MANGIL, INC_.,
-a
Florida corpora on, who is personally kno n' me or who has
produced as identifio and who did/did
not take an oath. 1
My Commission Expires:
'OFFICIAL NOTARY SEAL•
NOTARY .B C STATE OF FLORIOq
MY Commission Exw. July 5, 1995
Bonded thru General Ins. Und.
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