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HomeMy WebLinkAbout0950 '~'7249~3 STATE OF F'LORIDA CQ~Jt~TY OF ST . T.UC I E NON-FOREIGN AFFTDAVIT SAGE OF REAL PROPERTY iNTER~,ST Before me, the undersigned authority, duly authcrized in the } State and County aforesaid, personal?y appeared El~WAKU ~ AMFJKO ANG VERONICA M. AMEJKO, NIS WIFE, who deQoses and says: ~ . That declarant is Gellir.g the real pr~perty located at : 286 Brunson Court, in the City of Port St. Lucie, County of ' St.Lucie, State of Florida, described as: _ Lct 9, Blo:.k 3227, Port St. Lucie, Flore$ta Pines, Unit 2, according to the Plat thereof as recorded in FZat Book 16, Fages 37, 37~ throunh 37C of the Public Records of St.Lucie County, Florida. ~ Tt-,at this dec:laration is made for the benefit af the ; purchasers, Paul Gaumond and Lorette ~aumond, his wife, for : compliance with the Federal T3x Ref~rm Act of 1984. Tha~ the declaran*'s United States taxpayer ~ identifi~ation numbers are 048-07-2408 and ' 043-09-I359 respectively. i+ 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. ~ Declarants' home address is I726 Hondo Avenue , Port St. Lucie, Florida. The declarant understands that this Affidavit may be di~closed to the Internal Revenue Service by the purchaser, ~ title in~urance agent or closing agent and that any false ' sta~tement made by the declarant could be punished by fine, imprisonment, 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 truth of the facts hereinabove set forth. . Under penalties of perjuzy, the undersigned hereby declares that the undersigned has (have) examined this Non- Foreign Affidavit ar.d to the best of the knowledge and belief , of~he Declaran~, it is true, correct and complete. ~ / ? ~L-~ L- f / L ~-~L y ~ ~ f.;~C- Y cs r a ~U EDWARD C. AMEJKO ~ VERONICA M. AMEJKO ~ ' ~ , . _ Sia~bl~l-.~ and subscribed before me ~ t ' s'•~ day of Ju] Y , 19~_. ~ ~ ~~"l. ~-~~t.~ - ; , ~~totax~i;Public rr~~j'"At~'co~.issian expires: This instruuient prepared by: „ , Jorn F.c'.gar Sherrard, r,squire Notary pubHc; S'ate of F!orida at ~a!ge P.O,Box 4332 MY Commissi~n E~~:-es FeS~uary 5, 1990 Ft. PierCe, FI. 33448 Bonded thrc P,-~ t'; ~;~?ary Brokerage '7'724~~ '86 .RR 25 A 9 :0~ ~ Fi~; - ~ ~ ROGE~ . ST.lu~f; < <i(~ *e `~1 ~ ~'.'t ~~?A! 1 . - - ~ . ~ _ . _ - . _ L. . . . f:_~,~,,;",~''`iy "'s+'~v'-`*" .~~s.~ ~ .~2,.-~ ~