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QUALIFIED SUBSTITUTE <br /> STATEMENT OF SELLER CERTIFICATION OF NON-FOREIGN STATUS <br /> Buyer(s): Cube,Inc. <br /> Seller(s): Estate of Dean Young <br /> File No: SA18020108 <br /> Property Address: 3555 Crystal Place,Orono,MN 55391 <br /> Section 1445 of the Internal Revenue Code provides that a buyer withhold fifteen percent(15%)of the <br /> property sale price if seller is a Foreign Person as defined in Section 1445(f)(3). <br /> Section 1445(b)(2) allows an exemption to buyer's withholding requirement when the seller provides <br /> the buyer with a Certification of Non-Foreign Status executed under penalty of perjury stating the seller <br /> is not a Foreign Person and Includes the seller's legal name, tax identification number and home <br /> address. <br /> Section 1445(b)(9)allows the seller to appoint a qualified substitute to provide a statement to the buyer <br /> executed under penalty of perjury, stating that the qualified substitute is in possession of the seller's <br /> Certification of Non-Foreign Status. <br /> The undersigned,being first duly sworn under oath,states under penalties of perjury that: <br /> 1. Estate of Dean Young,the Seller has appointed as the Seller's Qualified Substitute as defined in Section <br /> 1445(f)(6). <br /> 2. ,as the Qualified Substitute, <br /> a. Makes no representation regarding Buyer(s) FIRPTA obligations or the validity of the Sellers <br /> representations on the Seller's Certification of Non-Foreign Status; <br /> b. Is in possession of the Seller(s)executed Certification of Non-Foreign Status <br /> EXCEPT: ; <br /> (Name of any SeNernol providing an executed CeMficafion of Non-Foreign Stalin) <br /> c. Agrees to electronically store the Certification of Non-Foreign Status for a period of 6 years; <br /> d. Agrees to provide the Seller's Certification of Non-Foreign Status to the IRS If requested; <br /> e. Has not received any notice that the Certification of Non-Foreign Status Is false; <br /> f. Has authorized me,'s employee and closer,to execute this Statement on behalf of. <br /> 3. I, "4-Nti-►`r - •n, - d anno/don of a false Certification of Non-Foreign Status nor do I <br /> ha <br /> VII IJII4iV <br /> closed-- - ent Agent <br /> r <br /> STATE OF 1 I �t l: <br /> COUNTY s. :JArit4lil10 <br /> Sworn to and subscribed before me this 1.. lay of RAO 201=. <br /> --- MICHELLE R HUEBNER <br /> Nat* "�~;-� rr - ,- Notary Public-Minnesota <br /> ;- My CommIselon Expires Jan 31,2022 <br /> 1 BUYERS)ACCEPTANCE OF QUALIFIED SUBSTITUTE STATEMEN ,i i '' " ' A 10 0 <br /> I. EMPLOYEES ARE NOT AUTHORIZED BY LAW TO PROVIDE ADVICE REGARDING ANY LEGAL OR <br /> TAX MATTERS. <br /> II. BUYER(S) ARE ADVISED TO SEEK LEGAL AND TAX ADVICE REGARDING FIRPTA AND FIRPTA <br /> COMPUANCE. <br /> III. 'S ONLY LIABILITY IS AS THE HOLDER OF THE CERTIFICATION OF NON-FOREIGN STATUS AND <br /> THE CERTIFICATION AS STATED ABOVE. <br /> IV. BUYER(S) ACCEPT 'S QUALIFIED SUBSTITUTE STATEMENT AND HEREBY INDEMNIFY AND <br /> HOLD HARMLESS FROM ANY LOSS OR DAMAGE RESULTING FROM THE BUYER(S) FIRPTA <br /> OBUG• 'ON' -!r- THE SELLER' ` - ION STATUS. <br /> Cube,In ;! <br /> Aggif ^ C;,...27,„ g 7.,. . <br /> '' Date <br /> 2 of 2 Rev.7.26.15 <br /> Codification of Non-Foreign Status(Personal Representative) SA18020108 <br />