February 26, 2013 - Laserfiche WebLink

Home Browse Search

� ��-- Real Estate Transfer Statement � Ne6raska Pepartment ot � � REVENUE •Ta�filed with the Hegister of Deeds. •Read instructions on teverse side. THE DEED WILL NOT BE RECORDED UNLESSTHIS STATEMENT 15 SIGNED AND ITEMS i-25 AR�ACCURAT�I.Y CpMPLETED 1 County Name 2 Counry Number 3 Dale oi 5ate 4 Data of Deed HALL-40 Mo.��._ Day�—Yr. �_�� Mo. 0z bay �6 v� 2D13 5 Grentor's Name,Address,and Telephone(Please Print) 6 Grantee's Name,Address,and Telephone(Please Print) Grantor's Name(Seller) Grantee's Name(euyer) County of Hall,Nebreska Wilbeth, Inc. SVeet vr Other Mailing Address Street or Other Mailing Address cJo Marla Conley,Hall County Clerk, 121 S.Pine St. 4400 S.Lewis Bivd. City State Zip Code City State 2ip Code Grand Island NE 688D1 Sioux City IA 51106 Teiephone Number Telephone Number (308)385-5080 (712)252-6500 7 PROPERTY CL.ASSIFICATION NUMBER.Check one bax in categories A and B. Check C ff property is also a mabile home. (A)5tatus (e)ProPertY7Ype �C� (1)�Improved (1)Q Single Family (4)�Industrial (7)Q Mineral lnterests-NOnproducing (9) �StateAssessed (1)�Mobile Home (2)Q Unimproved (2)Q Multi-Family (5)❑Agricuttural (8)�]Mineral Inlerests-Producing 10) ❑F�oempt (3)Q IOLL (3j Q/ Commercial (6)Q Recreational 8 Type o(Deed � Corrective �Land ConTract � Personal Rep.� 0ill of Sale 9 IRC§1031 Exchange? ❑Yes Q No �Warranty ❑ Sheriff ��wecutvr � Mineral �Cemetery (Was the transfer an IAS like-kind exchange?) Q�utt Ciaim � Conservator �Partition � Trust []Other 10 Type of Transfer �Sale GiFt Foreclosure �Revocable Trust �CouA Decree SatisfaCtion oi Contract �Auction �Exchange ��rfe Estale �Irrewc�.able Trust Pertition OthOr(Euplain.)Payment of�pR eand 11 Was ownership transierred in full?(It No,explain the division.) 12 Wa5 real estate purGhased ior same use?(If No,state the intended use.) 0 YES ❑NO �YES ❑NO 13 Was the vansfer beiween relatives,or if to a trustee,are the Vustor and heneficiary relatives? (Ii Yes,d�eck ihe appropriate box.) ❑YES ❑� NO ❑Spouse ❑Parents and Child �Famiiy Cwpaafion,PaMership or LLC �]Grandparents and Grandchild �Brothers and Sisters []Aunt or Unde to Niece or Nephew ❑Other 14 What is the cunent market value of the real properry? 15 Was the mortgaga assumed7(ItYes,state the amount and interest rate.) $4��,FJO3 ❑YES aQ NO $ � 76 Does this corrvtlyance divide a current parcel oi land? 17 Was iransfer ihrough a real estate agent7(If Yes,include the name of the agent.) ❑Y�S ✓n NO ❑YES �J NO. 1$Address Of Property - 19 Name and Address of A'ersOn!P Wtrom Tau Stetement,Shou�d bB 5ent 2314 E. Highway�30 Pam Davies, Wilbeth, Inc., 440Q 5: Lewis Blvd. Grand lsland, NE .�880� S+oux City, IA 59106 20 Legat Description Lots Three (3) and Four (4), Bosselman Brathers Subdivision in the City of Grand Island, Hall County, Nebraska 21 If agricultural,list tofal number pf acres 22 Total purchase price,including any liabilities assumed .............................................. 22 1.00 23 Was nonreal prnperty included in the purchase? ❑YES � NO(If Yes,enter amount and attach itemized IistJ.. 23 24 Adjusted purchase price paid for real estate(line 22 minus line 23)............. ' 1 00 25 If this transfer is exempt from the documentar stam tax,list the exem tion number ��nd 3 T U a na ia cnrract,and that I am duly aulhorized to slgn this statement. Lancaster (308)385-5093 Print or y e Name oi rantee Authorized Represen tnre Telephone Number $Ngn Chairman, Hall County Board of Supervisors 02-26-2013 here S�9nature of Grantee o th ized RepresentatHe 7itle pate REGISTER OF qEEDS'USE ONL.Y FOR pEPT.US�ONLY 26 Date Deed Recorded 27 Value of Stamp or Exempt Number 28 Deed Book 29 Deed Page 30 Mo.�Da �Yr. � � � � � � NaWa9ke Deparhnent of Revenue Aulharized 6y Ne6.Rev.Stat.§§78-21a,77-1327 Fortn No.98-288-2000 Rev.B-2p11 Supersedea 98-26&2006 GRAN7EE—Please retain a copy of this dceument for your records.