HomeMy WebLinkAboutNon-Foreign Affidavit - Phase IIIa NON-FOREIGN AFFIDAVIT
Phase Illa
STATE OF INDIANA
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COUNTY OF�/ irdr�/ n)
/"Cc,2a/c( L- (r'e/-4 N-(the "Affiant"), in his capacity as the Ur.c ?_7/1-es r cfeth"The City of
Carmel Redevelopment Commission (the"Transferor"), states that Transferor is transferring to Pedcor
Office, LLC (the"Transferee"), the United States real property interest more particularly described on
Exhibit A, attached hereto and incorporated herein by reference (the "Real Estate").
Section 1445 of the Internal Revenue Code of 1986, as amended (the "Code"), provides
that a transferee (buyer) of a United States real property interest must withhold tax if the transferor(seller)
is a "foreign person"(as that term is defined in Section 1445(f)(3)of the Code). To inform Transferee that
Transferee is not required to withhold tax upon disposition by Transferor of the Real Estate, Affiant
hereby certifies the following on behalf of Transferor:
1. Transferor is not a "foreign corporation", "foreign partnership", "foreign trust", or
"foreign estate" (as those terms are defined in the Code and the Income Tax Regulations
promulgated thereunder);
2. Transferor's United States employer identification number is 35-6000972.
3. Transferor's principal office address is do the City of Carmel, Indiana, One Civic
Square, Carmel, Indiana 46032, Facsimile: 317-844-3498.
Transferor understands that: (a)Transferee may disclose this Affidavit to the Internal
Revenue Service; and (b)any false statement contained in this Affidavit may be punished by fine,
imprisonment, or both.
Under penalties of perjury, Affiant certifies that: (a)Affiant has examined this Affidavit on
behalf of Transferor; and (b)to the best of the knowledge and belief of Affiant, this Affidavit is true,
correct, and complete. Affiant further certifies that Affiant has authority to sign this Affidavit on behalf of
Transferor.
THE CITY OF CARMEL
REDEVELOPMENT COMMISSION
By: _are" /1-17/7-7fq
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ACKNOWLEDGMENT
STATE OF INDIANA )
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COUNTY OFQfifcli--e0)
Before me, a Nptary Public in and for the State of Indiana, personally appeared
C—al--e i, the Kw Oeside.4 of The City of Carmel Redevelopment Commission, who
acknowledged the execution of the foregoing Non-Foreign Affidavit on behalf of such entity.
WITNESS my hand and Notarial Seal this 5 day of Dec(Litt �'�F, 2004.
Notary Public
Printed Name: P`7(///•S 0--/itk'fl SS9/
I am a resident of &1;
File No.: 2043417
EXHIBIT A
(Phase III)
Part of the Northeast Quarter of Section 36, Township 18 North Range 3 East, in Hamilton
•
County, Indiana, more particularly described as follows:
Commencing at the Northeast corner of said quarter section; thence South 89 degrees 12 minutes
13 seconds West along the north line of said quarter section 1,177.71 feet; thence South 00
degrees 12 minutes 13 seconds West 26.53 feet; thence South 00 degrees 46 minutes 33 seconds
East 554.73 feet; thence South 89 degrees 48 minutes 03 seconds West 60.05 feet to the western
right-of-way line of Third Avenue as described in the deed to the City of Carmel Board of Public
Works, recorded as Instrument number 99-9923663 in the Office of the Recorder of Hamilton
County, Indiana; thence North 00 degrees 46 minutes 33 seconds West along said western right-
of-way line 162.24 feet to the southeast corner of Carmel City Center Phase 11-East Parcel,
described in the deed to Pedcor Office, LLC, recorded as Instrument number 2004-22999 in said
Recorder's office; thence South 89 degrees 58 minutes 22 seconds West 197.13 feet along the
south line of said Phase II to the southwest corner of said Phase II and the Point of Beginning of
this description; thence South 89 degrees 58 minutes 22 seconds West 124.83 feet along the
north line of the land described in the deeds to Pedcor Office, LLC, for Carmel City Center Phase
I, recorded as Instrument numbers 2003-59244, 2003-59245 and 2003-59246 in said Recorder's
office; thence North 00 degrees 00 minutes 00 seconds East 139.77 feet to the southern right-of-
way line of City Center Drive described in Transfer Parcel 2 to the City of Carmel Board of
Public Works, recorded as Instrument number 2004-22998 in said Recorder's office; thence
South 89 degrees 54 minutes 04 seconds East 124.83 feet along said southern right-of-way line to
the west line of said Phase II-East Parcel; thence South 00 degrees 00 minutes 00 seconds West
139.49 feet along said west line to the point of beginning and containing 0.400 acres, more or
less.
NOTE: The acreage shown above is included for descriptive purposes only. The policies, when
issued, should not be construed as to insuring the amount of acreage included therein.