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2010/08/18 Council Agenda Packet
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2010/08/18 Council Agenda Packet
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Council Agenda Packet
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8/18/2010
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9 <br /> EXHIBIT C <br /> FIRPTA CERTIFICATION <br /> Section 1445 of the Internal Revenue Code provides that a buyer of a U.S. real property <br /> interest must withhold tax if the seller is a foreign person. This Certification is provided by <br /> Gary K. Brouse and Wendy J. Brouse, husband and wife, ("Seller")to the City of Everett <br /> ("Buyer") in connection with the sale of certain real property by Seller to Buyer. To inform <br /> Buyer that withholding of tax is not required upon our disposition of a U.S. real property interest, <br /> Seller hereby certifies the following: <br /> 1. Seller is not a nonresident alien for purposes of U.S. income taxation; <br /> 2. Seller's U.S. taxpayer identifying number(s) (Social Security number) is <br /> & ; and <br /> Gary K.Brouse Wendy J.Brouse <br /> 3. Seller's address is Gary K. Brouse and Wendy J. Brouse, 332 120th Street SE, <br /> Everett, WA 98208. <br /> Seller understands that this Certification may be disclosed to the Internal Revenue <br /> Service by Buyer and that any false statement we have made herein could be punished by fine, <br /> imprisonment, or both. <br /> Under penalties of perjury, Seller declares that it has have examined this Certification and <br /> to the best of its knowledge and belief it is true, correct, and complete. <br /> Dated and effective as of the day of , 2010. <br /> GARY K. BROUSE <br /> WENDY J. BROUSE <br /> 25 <br />
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