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STATE OF FLORIDA
COUNTY OF ST.LUCIE
NON-FOREIGN AFFIDAVIT
SALE OF REAL PROPERTY INTEREST
Before me, the undersigned authority, duly authorized in the
State and County aforesaid, personally appeared CIRA STEINBERG,
who deposes and says: c
That declarant is selling the real property located at
Unit No. 7, 2605 St. Lucie Boulevard, in the City of Fort
Pierce, County of St. Lucie, State of Florida, described as:
See attached Exhibit 1
That this declaration is made for the benefit of the
Lorrinda C. Reardin for compliance with the Federal Tax Reform
Act of 1984.
That the declarant United States taxpayer identification
number is ~ ~_~~_~~q~ • ~
That the declarant is not a nonresident alien for
purposes of United States Income Taxation nor is declarant a '
foreign person subject to withholding provisions of the above-
referenced Act. ~
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Declarants home address is 2105 N. W. l0th Place, Delray ;
Beach, Florida. ~
The declarant understands that this Affidavit may be
disclosed to the Internal Revenue Service by the purchaser,
title insurance agent or ciosing agent and that any false
statement made by the declarant could be punished by fine, ~
imorisonment, or both. The declarant will testify, declare, or ~
; certify before any tribunal, officer, or person, in any case ;
~ now pending or which may hereinafter be instituted, to the ~
s truth of the facts hereinabove set forth. ~
;
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~ Under penalties of perjury, the undersigned hereby
~ declares that the undersigned has (have) examined this Non-
~ Foreign Affidavit and to the best of the knowledge and belief
~ of the Declarant, it is true, cor~t a~nd mplete.
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CIRA ,S INBERG ,
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~ SWORN toTand subsc ibed before me ~•.r.~:
~ this ~=j day of ~r.i~ , 1985. ~ ~ _
~ Notery~u r: SF3te of F~:~. . ` ; - _
My Co :~:r.us~cn [r.~~r~: ~L13y 13, i9&9 ~(a~;l.~ : > : ~;i
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My commission expires: `-•"..,'v`~•
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~ THIS INSTRUMENT PREPARED BY:
John Edgar Sherrard, Esquire
P.O.Box 4332
~ Fort Pierce, Fla. 33448
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ac~riK 4~9 ~at;F ~.~9
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