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Certificate of Real Estate Value <br />KLOTSCHE, ALLAN J.1710 £..iao''wood Rd., Orono 471-0331 <br />SaHv t LMi f <br />FELTES, BERNARD F. <br />mourn cd <br />521 North Riverside Dr.» PoapanoBeach# FL <br />Otf Of Mmmtihm CoMf^y <br />2760 ShadyMQ Q(L_Ad._______ <br />Lift qT f^pt~ir (fiM m lot feiotii <br />rir r>nn <br />Of*d piat r^OfOO 0» •Wochi 9 ooo*** <br />Tract A Regis tered Land Survey No 1196_ _ _ _ _ _ <br />Mannmpit^ <br />Jip9 o! Acquisition (check ail boxes whtc ^ apply) <br />Q M fo«of 'Mm Q <br />or iiimaiai atw a <br />ri ^ooaHy «t a or iwho»Mar<ca <br />n rOCO**a0 Of«OOrfy ifi a oa#o <br />n SooOf ft a «M| 0i •!I 1 %o pofC»<a>aO 0»»<«a* <br />Moo 10 ot OO oap oor i <br />lo# Ma OBOi lool • ti%| <br />CO #Ori«I 1 Data o«MCitaaod afioo fwowt ofooi ta <br />0««r Hao voart afO iFiO M yoot II ■ -m» to# piooait y <br />If you checked any box above, skip the rest o/ this form, sign it and fin out schedute B <br />Typ* of Property Transferred (check all bo»es which apply) <br />[~1 D ex**"^*r~l C«nM<vcMi« U t WfXxf <br />OMor JOfHiOVf lOffOorotMla <br />Planned Um of Property (check one box) <br />r3 HatrOOrHia' ('•O'^'l) Cl <br />n a«.*oeNw«ai Q Commorciaf mOsrotnaf <br />Hyoo onHtatnaas ----- <br />(tOuwibar fl# ufM«I 1 CaOra Of WOOlOOtiOWil <br />n Qmof UMtiotGriSf ^o«l <br />Financial Arrangensenis (instructions are on back of yellow copy) <br />f lolof Pu'cf^aaa ^cc f Tolai Amoufft of f^raofwN ^oovty <br />flrom tClMflO A on boc* of tbio tilOtU <br />I Data SiiOf AgPOOtf li <br />42-7^,ooa., oa <br />i Oo«m PaymOfil <br />i_5Q ,.QQCu oa <br />40/46/03- <br />ft Aoimt or PrOM*^ Intarest POKl by Soi>0'6 Ao«mt Of f*r00Oi4 l(«taratt Po*b by SvyOf <br />Describe eech mortgage and confracl fof dBOd used to purchase this property <br />i«m<s t <br />Contract m <br />Ataurm-O <br />Mortfago^ <br />Vet No <br />' BD □ <br />. □ □ <br />. □ □ <br />Moriqaga or Corttract for Oaad <br />Amount at Purchaaa <br />Mcwilhlv Plyrnar^f for <br />Ptmcioai arvd tmeresf <br />inter#§l «OtO <br />ftn tftact Now) <br />Total NumbOf <br />ol fa ymanf <br />Don Ol Any Lamp Sum <br />(BoNoon) PaymonN <br />-$275,DOO xjOO- -44-744.42--V-1-/99- <br />•• H a nwtqafl. o. co«..aci i«. .a..abtt. ma.ka< .a» bui it» i...n» o« pa,m«ri a.* «;b»d«la« to chaf^ on a I..O0 Wlo wt m .ta h«o «o»Ow Lorn abo.0. Wo <br />montn arrd yaar ol th* cHarsqr and (*♦>»! ii «nil changa lo lor attach 3 cop*af of p«y»r»ar'l achodiil#) <br />Fill out schedule B on the back of this sheet to determine the amount of your deed tax <br />jlMire Nn annoAfV)