2000-11-14 Certificate of Real Estate ValueBuyers' last name(s), first,
Certificate of Real Estate Value
e initial Address Daytime phone
C.l-k of X1,141-161,11
Sellers' lost namee(s), first,middle initial
Street address or rural route of
Date of deed or contract
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Financial arrangements
Total purchase price
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Down payment
Points or prepaid interest paid by seller
J / 2?,
I f6- r Zr4rcrr
Legal description of property
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Daytime phone
PE-20
?VT -yr? If., -
C*ij or township Count,
usrchosed (lot, block and plat, or attach 3 copies of the legal description)
Was personal properly such as furniture, inventory or uipment included in the purchase price? If yes, ❑ yes nc
descnbe below and list current (not replacement) valuejUse the back of this page if needed.) p
$ $ Total personal Property
current value:
$ $
Type of acquisition (check all that apply)
❑Buyer
and seller are relatives or
related businesses
Transaction involved the trade of
❑ property
Buyer is a unit of government
"
❑
Property is a gift or inheritance
❑ Buyer is a religious or charitable'
❑ Condemnation or foreclosure
transaction
organization
❑ Payoff or_ resale of contract
Type of property transferred (check all that apply)
❑
Land only
Land and buildings
ElConstruction of a new building
after January 1 of year of sale
❑Name added to or co -owners name
removed from deed (not a sale)
❑ Buyer purchased partial interest only
❑Purchase agreement signed over two
years ago. Year sign
Planned use of property (check one)
Residential single family IFY—d k—ofthefatwboxesbebw.ymnwsroompleleed+e"PE-2DAatdaMadtMod iscerliRcale.
❑Residential duplex, triplex Agricultural Commercial -industrial
❑ (number of acres:) ❑ (type of business:)
Cabin or recreational --
❑ (non-commercial) ❑ Apartment building
(number of units:) ❑Other (describe:)
Will this property be the buyers principal residence? ❑ yes Kno
Method of financing (complete only if seller -financed, including a contract for deed or assumed mortgag_
Check: Mortgage or contract for Monthly payment for Interest rate Total number Date of any lump sum
Assumed Contract ddeee .mg`ount at purchase principal and interest now in effect of payments (balloon) payments
Mortgage for Deed
❑ ❑
® ❑ ❑
I declare that the information on this form is true, correct, and complete to the best of my knowledge and belief.
Name (print or "I X;4�
Phone Date
�`. C.' W,. • Cry if `fl'? � 1a l/- /y-rry
Co Trow SD Yr land BldgTot - -- - - pe --
Inc f l I
Primary Property iderifiRcation❑ T I I -
Good for study ❑ Yes ❑ no If no, give reason/code
X JHC IST
Co ICT
PT IDate I T I M I S
Secondary parcel id"fication N
6
c
d
Are there more than 4 parcels? ❑ yes ❑ no
Put extra numbers on back.
Stock No. 6MAW
(Rev. 6/%) DEPARTMENT OF REVENUE COPY 750986
Buyers' Jocial Security; numbers (or Minnesota or reaerai t.0 numoersl aemn aocim �ecuriry �slumoers for minnesora or reaerai i:v numoerst
W-7/_ Iq7 12 2 f