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HomeMy WebLinkAboutDeeds & Easements_23-2019EEXHIBIT "B" GRANT DEED RECORDING REQUESTED BY WHEN RECORDED MAIL TO City of Redlands P O Box 3005 Redlands, California 92373 Attention City Clerk APN 0169053 11 (Space Above for Recorder's Use) GRANT DEED The undersigned Grantor declares that Documentary Transfer Tax is not shown pursuant to Section 11932 of the California Revenue and Taxation Code, as amended FOR GOOD AND VALUABLE CONSIDERATION, the receipt and sufficiency of which is hereby acknowledged, CITY OF REDLANDS (the "Grantor"), hereby grants to BAKTI LUMINTA and YUNITA HERAWATI, husband and wife as joint tenants , an individual, the real property in the City of Redlands, County of San Bernardino, State of California, described in Exhibit "A" attached to and incorporated in this Agreement by this reference THIS GRANT AND CONVEYANCE IS MADE AND ACCEPTED SUBJECT TO COVENANTS, CONDITIONS, RESTRICTIONS, RESERVATIONS, RIGHTS OF WAY AND EASEMENTS NOW OF RECORD [signature page follows] MAIL TAX STATEMENTS TO City of Redlands P O Box 3005 Redlands, California 92373 Attention City CIerk IN WITNESS WHEREOF, the Grantor has executed this Grant Deed as of .23 , 2019 GRANTOR CITY OF REDLANDS, a municipal corporation B ATTEST e Donaldson, City Clerk Paul W Foster, Mayor CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 ��-..'ea;N!! `'2� '¢ 2�2 2ei,:2efZ:'.,2 a 2 2 ¢moi tefn2e.VWRI a2eiq.c!"v.. 2!? 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A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document State of California County of van ge✓aarS- i o f ) On 071;3120i 9 before me, Bre-+d o &o'?, Date T personally appeared Pu.EW r0S- ' anoL Yen,.nne, Don4i1 dSo7 Name(s) of Signer(s) 1\1046r� P,r Iic1 Here Insert Name and itle of the Officer who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct BRENDA BOON Commission # 2146092 Notary Public Calilornia San Bernardino County M Comm Ex fires Mar 13, 2020+ Place Notary Sea! Above WITNESS my hand and official seal Signature OPTIONAL Signature of Notary Public Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document Description of Attached Document Title or Type of Document Crcr .r'1-}- Dee Document Date 07 I7b' °i Number of Pages Jr Signer(s) Other Than Named Above N fi Capacity(ies) Claimed by Signer(s) Signer's Name Pau. 11:'J r o 1 ❑ Corporate Officer — Title(s) E Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator IX Other 1 n.,c ( Signer Is Representing Cl+ al. IandS Signer's Name ,Tzars ne. D o nri t c s o ❑ Corporate Officer — Title(s) ❑ Partner — E Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator X1 Other CI- , Signer Is Representing C!+i ked(c?ei [S L' IOSI..4S,1•.S.4,,e9�y'ti.642:5.'NA.6S+A,221'bu4\II.vIelgAeC✓.4,,A174 4,A!.4,,,e'7.%3\ge5.A!'=�4+s/4,2/4.4.0. \le4vLViNge.41'� .' .1.4.1,14 11:%S,te4L4VLcle,4,1,1.. ©2014 National Notary Association • www NationalNotary org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 EXHIBIT "A" TO GRAND DEED LEGAL DESCRIPTION APN Number 0169-053-11-0000 LOT 1 IN BLOCK A OF VALLEY VIEW ADDITION, IN THE CITY OF REDLANDS, COUNTY OF SAN BERNARDINO, STATE OF CALIFORNIA, AS PER MAP RECORDED IN BOOK 15 OF MAPS, PAGE(S) 14 RECORDS OF SAID COUNTY Document No Recorded , 2019 STATEMENT OF TAX DUE AND REQUEST THAT TAX DECLARATION NOT BE MADE A PART OF THE PERMANENT RECORD IN THE OFFICE OF THE COUNTY RECORDER (PURSUANT TO SECTION 11932 REVENUE AND TAXATION CODE) TO Recorder County of San Bernardino Request is hereby made in accordance with the provisions of the Documentary Transfer Tax Act that the amount of the tax due not be shown on the onginal document which names Grantor CITY OF REDLANDS, a municipal corporation Grantee BAKTI LUMINTA, an individual The property described in the accompanying document is located in the City of Redlands, County of San Bernardino The amount of tax due on the accompanying document is $ Up. CD , computed on the full value of the property conveyed (Signature of Grantor or Agent) CITY OF REDLANDS, a municipal corporation ATTEST e Donaldson, City Clerk Paul W Foster, Mayor Note After the permanent record is made, this form will be affixed to the conveying document and returned with it EXHIBIT "C" NON -FOREIGN AFFIDAVIT STATE OF CALIFORNIA ) ) ss County of San Bernardino ) The undersigned, as authorized agent of CITY OF REDLANDS, a municipal corporation ("Transferor"), after being duly sworn upon his oath deposes and says that Section 1445 of the Internal Revenue Code provides that a transferee of a U S real property interest must withhold tax if the transferor is a foreign person To inform BAKTI LUMINTA, an individual, ("Transferee"), that withholding of tax is not required upon the disposition of Transferor's interest in a U S real property interest, the undersigned hereby certifies the following 1 Transferor is not a non-resident alien, foreign corporation, foreign partnership, foreign trust, foreign estate, or other foreign person within the meaning of § 1445 and § 7701 of the Internal Revenue Code and the treasury regulations promulgated thereunder, 2 Transferor is not a disregarded entity as defined in Treas Reg § 1 1445-2(b)(2)(iii), 3 Transferor's U S taxpayer identification number is 95-6000766 4 Transferor's business address is 35 Ca on Street Redlands, CA 92373 Attention City Clerk Transferor understands that this certification maybe disclosed to the Internal Revenue Service by Transferee and that any false statement contained in this Agreement could be punished by fine, imprisonment, or both Under penalties of penury Transferor declares that it has examined this certification and to the best of its knowledge and belief this certification is true, correct, and complete The undersigned agent declares that he has the authority to sign this document on behalf of Transferor ATTEST e Donaldson, City Clerk TRANSFEROR: CITY OF REDLANDS, a municipal corporation aul W. Fo ter, Mayor A notary public or other officer completing this certificate verified only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document STATE OF CALIFORNIA COUNTY 0 liti.di;o0 ' 2019, befor�tne, i'1it !.. «./A :} _ blic, personally appeared , I 17glri,,}Ma, ' I;.1 ► n iVT.,4 r, , who proved to me on the basis of satis actory eviden. - to be the person(s) whose name(s) /are subscnbed to the within instrument and acknowledged to me t t h4/se/they/executed the same in sr/their authorized capacity(ies) and that by lis/hjr/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument ss I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct WITNESS my hand and official seal L R. MCCASLAND Commission # 2143166 * !q-•• fix_ Notary Public California Riverside County r M Comm Ex fres Feb 19, 2020 Nota Tub is In and For Said County and State