|
PF-20
<br />11_-_�"
<br />'W.�Rav_ Certlflcate of Real Estate Value
<br />" _
<br />-—, -09
<br />Name Fi,ltt Middle 'l; if Present Address
<br />-Home rs Inc. -and Fitioiald Conist.-I n- de , , 'il�
<br />4
<br />Justi, ne
<br />7�
<br />liria Phone Number
<br />Sellers lastName, First, Middle Initial -Address
<br />aytime Phone Number
<br />-Jack E. Canfield, Amy M. Canfield, Eileen F. Weber
<br />Elizabeth Ann Weber, Jean F. Haag, RaymondHaag G.
<br />'.",Street Address or Pura! Route of Property Purchased
<br />or Township County ,
<br />� v,,, Legal �esenptton of Property Purchased (Fill to lot number, block number and plat name, or attach 3 copies of the legal description)-e::r;,: .- '-.t ;>.-�z��".'
<br />- the tiWi J of the Sint!$ , Sect #are 2i, Township 3 i ,' Range 22, Artois county,_Alnneslota
<br />, Excel
<br />Counter,' Xllnnssot;
<br />-Type of Acquisition (check all boxes which. apply) , A'
<br />21,;
<br />-5
<br />0,
<br />'You and seller are relatives st r 3rbtrBuyer is a religious or., ur name idd4d
<br />or related businesses charitable organization name r6movki fri:
<br />You Property is.a,gift Or Inheritance ❑I au, purchased
<br />Y., s nit of government 1,v
<br />4,,
<br />do ❑'eou condemned closed Ybu`�eiiii" prbp�riyin.t;�' or late Date purchased a
<br />the Property - over two years ag,
<br />Yes No
<br />vg
<br />317 00, ro
<br />6M .!L
<br />7b
<br />T
<br />-,10 If a mortgage or contract for deed is not a variable market rate but the terms of payrnent are scheduled to change on a fixed date, fill in its line
<br />ne number from above, the
<br />month and year of the change, and what it will change to (or attach 3 copies of payment schedule): -44
<br />Fill out schedule 8 on the back of this sheet to determine the amount of your deed fax
<br />I declare that the information filled in on This form m trijiP. CorreCl and CoMplat* to the tragt Of my knpwledge and b9ilip?,
<br />Wint or type name of person Signing this form Signature -Phone Number Date
<br />0ouglas' J. Ochn 421-5424 1-9-90
<br />r,,�, T 11 le Use
<br />GA
<br />Cc CT
<br />Bldg Tot Plat —Parcel
<br />Post -It' brand fax transmittal rnarno 7671
<br />TO P�P_Ty Fro"'T,, 6 6 5-
<br />Co. Co.
<br />M
<br />4� 1_#Ktf S Cc). ASS,-5SO`�
<br />Dept. A
<br />—i'll < Phone t�76o K
<br />Fax + _ r;,r t
<br />
|