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MÂtf,¡s, REVÉNU E SERVTCËs

RñA t ESTAIË TRANSTÈR TAXDECIAFATION

3ó M.R.S.954641.4641N

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RETTD

MAINE REVENUE SERVICES

REAL ESTâTE TRANSFER TAXDECLARATION

TTIE 36, M.R.S.A SECnONç 5$4641 4641N if üå$r--år,'kiåäïii.;i"

2-

3.GRÂ!¡T(É/PURCHASCR

SELLER

55É5 t'3SOOI(PAGÈREG FTRY U SE O NLY

4.

I

FED. &

Addrers

^ 4o)St¡rs 4h)ZrpCodcqlGir-lÏBOU

f'pROpERtry 5å) ráåp

ó,TRANSFEßTA,\

7.

9. SPÉClAt CIRCITmSfANCES-t¡tlere thøe any rpeclal drcr¡mÍanc€rfn rhe üansfervrhich sugge¡t thrt lhe price pafdwas eithe¡ moreor lessthan is fatr ma¡ket value? check the

Elock lol Sub{¡t

3L

5c) Phy¡tcal Loc|tloû

6a) Purcha¡e P¡lce (lf the tnnsfer ls a glft, ente¡'O')

ób)hir Marketvalue (enlera value only if you entered'0"ln 6a) orlf 6a) wa¡ of ncimioal value)

cl¿im- Chæk¡heboxrf íj

s,WARNINGTO

Checkanythat appþNotaxmaprorkt SdtAccrge

Multlpte parceb

Port'ron of parcel

6a

6b

tramler ¡ax and

ls claslfied as Farmland Open Space,Trce Gron¡th, orWorklog Water-

tr 10. INCoMETAt(WIIHHEI.D- tuye(sl not æquled to M¿ineíñqÌEÞxbe<åute:

Seller hasquah6ed as a [\4alne re¡ldent

A walve¡ ha¡ been received from the StateTax Asses¡o¡

Consldentlon forthe prcperty ls lesr rhan 550.000

foreclosuæSale

L41

fiont a ¡ubna¡tial ñnancÍol penaltycould be trggercd bydevelopmerit,subdnísìon, partil¡on orqhange In use

flcr¡ssr¡r¡o

27 5A0.0

II,OATH byTltla 3ó $48t1-( we swearoraffi¡rn we haveeachorJr l¡ lrue, ço¡rect

Deta 6rontor

6nÍtee+Oaté- Gnntor

retum and to the besl ofare requhed to slgn below:therr

D¡te-D¿te

-

TZ. FNEFAßEß Nameof Pleparer

Malling r4ddress

üNXPAÍIÜCK& AETS{ETT LAIT OFF¡CES PhoneNumber%"). P. O, 80X 28, CARTBOU. rrAtNE 04736

Fâi¡llAddress

Fax Number

paùick@canbouhw,com

(æ7)498S712

htlpy'/lvww.maíne,gov/revenue/propeÍ¡ttåltransfert¡ x/trôn¡fertaxJttm

llerits: 0011611396609 Trips: 31 62440670009

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RETTD

3.GRANTEE'PIJßCHASER

SELTER

MAINEREVENUE5ERVICESREAL ESTATE TRANSFER TÆ(

DECTARAÏIONnnE 36, M.Rs.A. SECÍIONS 554641464t N

hlED Jul 2012016 â 10¡t7q i84p{IrsnsfeÎ Eor of *176.009!g!ç-of toine Tnqnsfer ToxâRllOSTOflK SSr IIAINE

5Så5 É5SOOIVPAGE-ßEGIÍRY USE OIìLY

,¿ïlllsL

IME J

BOUfu)Strrâ ¡lhlZoCodc

EFird-l5.pROPERTY 5¿l Måp

6a) Purchase Price (lfthe transfer ¡s a gíft, enter'o')

ób) Fa¡r MarketVafue (€nteravalue only lfyou entef€d'0'in 6a) orlf (hlwa¡ of nominal value)

6dExempt¡on ctaím - Check the bo( ¡f either gnnrcr or grantee ls

fronr a íbsranrtal llnrnctal penaly could be rlEEered by

t, SPECIAL ClßCUL/lsrANCEFWele thøe any dlclmstancej 10.in rhe tramferwhlch ruggcstthuthe prke paldwas cither more orlegsthan ltr hk market vrlual

Aw¡fe

)D¡ Itpa0rPl0pffry-Ëñtarüþ<o{¡nuñ!fi lhålÞ.¡ldea<nbesúß progenybelng rold. (5€G hrtn¡<do.rs)ø

(hesk ¡r¡y th¡t apply¡Notox mopr exist 5d) Asc¡gc

filulüple p¿rcel¡

Portlon ofFarcel

6a

6b

fiomtaNfe¡Exand

Open Specc, fioe Growth, orlÁ/orldng Whter'.

ot_1_

Itame of heporer

MarlingAddnss

Lot

004Eloct 5ùb.fra

6.TRANSFERTA'(

7.

or dr¡noe ln use.

Ecrisruo

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thebor øtrEEl

wc hereþ træar oraffirm thatwe have cach

@!!l!!- Gantor

O¡te

-

Gontor

Pl¡onePO Bo< E€6

€.fllarl Addrcss

FaxNwnberCanbou. ME &736

nor requiled rowlrhholdlnometax becausel

$eller has quotlñed os a il¡lnc le¡tdent

A waþerh¿s been ecelved fromrhe StåteTo( As:e¡sof

Con¡lden¡üon forthe propenylr less than S5O.000

Foreclosure Sale

fêNm tô best ofrequiÞdto slgn below!

Date.ElE4!l!-Date.!80S9.-

ßolm¿n@€olmeDhuntet com

S

1

4 0000

7- 2AL6

((}lrec[

hnpt/www.mâf n¿,gov/revenre/propertytåx/trâñtlertax/tnncfe rt¿x,htm

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RETTD

3.GFA!¡IEVPURCHASER

1266

SEI.IER

MATNE REvENuEsERUfitftREAL ESTATE TRANSFER TAX

DECLARATION

TTTLE 36, M.RS.A. SECITONS 55464t.4641N

ROAD

00fi6fi396610 Trips: 3162'140670010

UËD Jql ?01201å Ð 03¡tóp tBEt2Tconsfer tcx ol $8?5.60Stote of llcine T¡unsfei TaxAR00ST00K 5Sr IIAINE

55bS- zzlF 5 édovpras-n¡o silRglrSÊ tiltlv

ffiW-s.PgOpÊRrY 5äl fri¡p uoo< lÐl $¡bLot

6a) PurchasePdce (lf thetraffifer15 a g¡ft,eôter'0T

6b) Fah MarketValue (enter a value only lf you entered'O'ln 6a) orlf 6a) was of nomlnalvalue)

6cl clolm Chackthe

oRCUMSÍANCES-WeIe any circum¡tanceg

$eck any that apply:Not ¡(maprêdrt

Muhfple parcefr

Podonofparol

5d)Aoorgc

6a

10. INCOMETTìxWTHHELD- Buyerlsl not requtred to wlthhold Mafnelncor¡e tax bec¿u¡e:

Seller hasquahñed a¡a Malne resldent

Awalvcr has beenrecelved fiom the StateT¿xAsesgo¡

Conslderatlon lor the propenytsle$ thÐ g5o,o0o

Foreclosure Sale

examined thls rotum and to the be¡t ofto Þlow:

10

sc)

51-A

6.IRANSFERTAX

7.

than lt¡ falr ma¡ket

T'.OATH

6b

grðnt€e üåtEfertaxand

S.WARNINGTO pmp€rg as famlrndopen ot Water-fionta subst¿ntlalf nondal pmaltycould be tdggered bydevelopm€nç suHlvlslon, panrüon or change fn u¡e,

CLASSIËIED

in the uansfer wl¡ich sugg$t that the pdcepald t'ras é¡ther more o¡less

Aware fotth byTltle 36 54641-lÇ we hereby swear or affilmIt 15 true,corect,änd cotnplÉte. Gran¡edt) and

oa¡e W-6entee- Dåto

-

NameofPreparer Gateu¡ayTíUe of Malne Phone

Molllng Addres -adl slele sfreel PrærIn lel¡ rltr lU{Â9 - -, FM¡il Addrest

Fax Numbert

APPLETON E M862

DARREL

794 Main Sfeet

SPR httpy'/wur¡r,mâlne.govÍancnue/propGrtytàrdlfaníertax¡ltran¡fertax.htm

l/lerit¡: 00lf 611 336301 Trips: 3l 62{a066lD00l

ililililil|tililtililililtffi tililililtil 00*0599900*

RETTD

ret Addr¡¡s

1f) Clty

MONMOUTH

MAINE REVENUE SERVICES

R EAL ESTATE TRANSF ER TAX.DECLARAT¡ON

TITLE M.R.S.A. SECTTONS 4641-4641 N

FftI Jul ?2r?01ó ô 08¡5fa *8EilóTrqnsfen tax of Sæ.20Stqte of llqine T¡ansfe¡ TaxAR00ST00I' SSr I1AINE

õ56s =55EOOIUPAGÊ*RE6I'I1Y UsE O,IIY

.ME .

3hl zrpcodå

.ç47s6 . ,

F JR

49ùSt!tÊ ¡lhlZlpCode

04259rJ-.trrJ-l-¡

PIEASETYPE OR PRINT CLEARLY

AROOSTOOKDO NOT USE REq NKIr.(ouNrY

2. MUNIqPÁUTT'TOWN5Tf, P

S.CRANÍEE'PURCHASEN

4.GRANÍOR/SEI.tER

S.PROPEÂTY

No laxmâps edst

lrlultlple parcels

Portlon olp¿rcel

023 -5ub'|,át

D3-NEW SVüEDEN ROAÞ cARlBOtt

fot

50Âcr.¡ge:ME

CheckaDy thätðpp¡!,:deadrber ùep.oDeûy

8lô(l

t-.¡-¡-l-t hrrrucdent X01

otrr ¿Á¿¡¿

6a) Purchase Prlce (¡fthe transfer ls a g¡fl enter'o') oa$,-r--r., . . :rqggg 00ób)Falr MarketValue (enterav¿lue only if you entered'0'lnóal orrf 6al was of nomlnal value) 6b$, .1, . ¡ ,.. ,., ..006clEtemptfon <laím- [ Checkthe boxrfelthergrantororgranteelrclatmlngo(empüonfiomtrânsfertaxandexplafn,'

6.TRANSTERTÆ(

'. DATË OF IñANSFER þ'N.DD.YYYYI

.0.7. .1.3. .2.0. t 6.

MONI}I DAY IÏAR

S.wARNINGfOSUYER-|f rhe proper¡y f5(tarlfhd ar Farüìtand, OpÊ¡ Space orTree Growth, a Subrranüal fnândôl penalrycould be ülggered by developrnen¡subdfvlrloñ, prdtton orchange ln ute

E cusstr¡go9. SpECIAL CIRCUMSIANCES-Wêre there ðny speclal df(um5r¡tces ln the úansferwhkh suggert that rhe plkepaldwasekher moreor le¡¡ rhan lsfalr ma¡ke¡ ì/atue?lfyes, <heck the boxand explaln:

tr totNçoMETAx wtIHHEtD- Suye(e) nolrequited rcGiññdifMôlÍe fnçome tax bec¡ute:

fl seiler tnar qualfr ed as a Matne reCdent

[A walver tras bee¡¡ recelved fiom the Stôre Tax A3senor

@Condderatton for lta properry ls less üran iS0,000tl. o^fll 36 9.|ó,ll-Kwe hereby a,ræar ol affrm thðtwc hâve each exarnlned lhls return and to ¡he be¡t

lrue, cor€ct, and complete, Granteelr) atd Grantor¡g orth€lrauúor¡¿edâ33et aÍ

a¡d belfef agent(s) arerequfred to slgn below:

Àwarcouf

Dåte-Oôte

-

D¡rrê

0ate

Glantor

-

12.PRË,PARÊR Nameoftrep.arer Richard K. Dubois, Esq. phoneNumber

dubols. rtchard. esq0 gmaílCaribot¡, ME 04736

1207t 496-3280

Mdlfng Addreis E MalAdd¡essP. O. Box 338

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MAINE REVËNUE SERVICESREAL ESTATE TRANSFER TN(

DECLARATIONïrrtE 36, M.Rs SECÍ|ONS 554641-4641N

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s.WAnNf N6rO BUYER-¡í the lsdas¡lñeda¡ 0penSpaceftont ð substândal ñnancfal penalty co.rfd be ulggued bydewlopmen¡ subdlvlston, pârt¡üon

Waterordrangeln ure

L!ct¡ssm¡o9. SPECIAL €IRCUMIIANCES-Wêíe there any sp¡dal ctKumst¡nceúln üre transfei wtrfch suggesr rhat úe prlce pald wæ efther mole or le¡s x lo.tN(oÑrE TA,YWTHHELD-Buyer(s) not requlred to wtthhold Maine

lhân lte falr market rralue? the box andorplafn: f,nrx

¡ncomeËxbecauseSdfer häs qualñed ðs a Mätne re5¡dent

A waiwr has ben recehrcd fipm the Sate1ãx Asser¡or

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00MAINE REVENUE SERV¡CES

REAL ESTATE TRANSFER TAXDECLARATION

TLLE 36, M.RS.A. SECnONS 594641-4&¡1 N

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8. propeny fs da$lfied äs Farmlan4 Open Sp¡oe,Trê€ Grovrrh,f¡ont a substannal ñnanclal penalty<ould be trlggered by deyelopment subdlvf¡f oD, pâItlilon oJChangeln uie.

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Consldentfon fo¡the prcperty ls fess than $50,000

ForeclosureSaJE

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7 L TO lsdaslfied o¡ Famland, Open Tree Growth, o¡Workrng WaGr-front ¡ substantlal 6nancfal panalty <oufd be utggered by developmen¿ subdivlloû, pârtùon orchange ln use

Llcussn¡oanyspedalckcumnances Xpafd wðs€¡thermoreor less 7]

to. lNcofrtE TÆ( wlT-H HEU'- Buyer{rl rot requlrcd Malne9. sPÉCIAL CIRCUMS¡ÃNCES-We'E rher€ln the ransfer wlu'ch sugg¡st th¡t the prkelhan lts falr market value? d¡edrúrcbox and

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Sdler has quahñed ar a Malne re6¡dent

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DECLARATIONTrTtE36, M.RS.A.SECT|ONS S5464r-464rN

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- ¡ A walver has been recelvod fiom the Sþtel¿x Anetþl, t- | Con¡lderar¡on for the property í¡ les¡ ¡han i50,000

clalm - Check rhe box ¡f ¡t from lronsfer tax and expla[n.

MRSÀ Soê. 1¡641-C and {2}- H¡ln€ SÈ¡te ås GouenT¡enÈal entlS,WARNINGTO prop€rly 13däiCÍed ar Farmland Open Space,Tree Growth, orWorklng Water-fiont a ¡ub¡tanûal ñnanchl penalg roufd be trfggered b,y developme¡t,

{641-C 1 and 2

Awareof penalller a9 ret tonh byltle 36 5,16ll-l(,we herebysrnearoraffim thlsre¡urn ånd to the best ofouf bsllaf, and complete Grailae{s} ùnd tre

subdlvflon, partrtron or{range in uæ.

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7. DATE OF TRANSFET ÍMM.OD.YYYYI S.rrVARNlNG TO BUYEfÈlf úteøoper¡y ltfiont a:ubsuntl¡l frnancral penalty corld

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ITflTHHELD-8uye(s) nor rÊqulred rowíthhotd Mat¡reíncome t¡x becau¡e¡

Seller hrr quahfied a¡ a M¡lne re¡rdent

A w¡fverhas been resefved fiom the $ote Tax Assessor

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MAINE RËlÆNUE SERVICESREAL ESTATE TRANSFER TAX

DECLARATIONTITrE 36, M.RS.A" SECïONS 554æ14641

Ierits: 00l16ll39Glll8 Trips: 3162440ô60008

FRI Jul 29flt16 ð 0?:12q tS8?1Trqnsfer tqx of *55.00$tote of llaine TrsnsfE¡. TqxAR00ST00K SSr llAlNE

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9. SpECIAL CIRCUMStrANCES-WêÍo therê any speclrl clf(urtlsrances l'st l0. lNCO¡ltETAXWlftlHEt O-Buye(s) not requlredm the mnrferwhÍch suggestrhôtthe pdce pãid etther more af less ¡ncome taxbecausetthan¡B fa¡rmilket clr+ck thebox ,7: Sellerha¡ qualfñed arå M¡lne

A wä¡ver hôs b€eñ reçeived fiom the Ståte Tâx A$€s'ror

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