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Burnett County Abstract Company,Inc.,25084 State Road 35 N, Siren,WI 54872 (715) 349-2269 <br /> File Number.BCA-22-0081-B <br /> Property Address: xxxxx Old 35 Road,Danbury,Wisconsin 54830 <br /> Sellers:Deborah L.Meyer and Michael T.Meyer <br /> Buyers: Todd Dennis Boyum and Stephanie Ann Boyum,Trustees of the Revocable Living Trust Agreement of <br /> Todd Dennis Boyum and Stephanie Ann Boyum u/d/t dated February 2,2014 <br /> STATEMENT REGARDING RECEIPT OF <br /> SELLER CERTIFICATE OF NON-FOREIGN STATUS <br /> The undersigned hereby states that: <br /> a. I am the Settlement Agent in the above referenced transaction("Transaction"); and <br /> b. I am an employee of Burnett County Abstract Company,Inc.,which is a "Qualified Substitute"; and <br /> c. That the following Seller(s),are all of the sellers in said Transaction: <br /> Deborah E..Meyer and Michael T.Meyer <br /> The undersigned confirms receipt of a Seller Certification of Non-Foreign Status ("Certification") for each Seller <br /> shown above purporting to be signed by the Seller,or a person representing that he/she has the authority to sign on <br /> behalf of the Seller,and confirms that each said Certification: <br /> a. States that the Seller is not a foreign person, foreign corporation, foreign partnership, foreign trust or foreign <br /> estate,as those terms are defined in the Internal Revenue Code and Income Tax Regulations; and <br /> b. Sets forth the Seller's name,taxpayer identification number,and home address(if the Seller is an individual)or <br /> office address(if the Seller is an entity); and <br /> c. Was signed under penalties of perjury. <br /> The undersigned makes no certification that said Certification(s) is/are accurate, correct, or complete. The <br /> undersigned is providintthis statement under penalty of perjury and declares that s/he has the authority to sign. <br /> Dated:March 25,2022 ��' <br /> Sandra Grilz,Escrow fficer/Closer <br /> Burnett County Abstract Company,Inc.will retain a copy of said Certification(s)for the time period required by the IRS. <br /> FOR INFORMATIONAL PURPOSES ONLY: <br /> Section 1445 of the Internal Revenue Code("IRC")provides that a transferee(buyer)of a United States real property interest must pay or withhold as a tax <br /> up to 15%of the total"Amount Realized"in the sale if the transferor(seller)is a"Foreign Person"and no exception from FIRPTA withholding applies.A <br /> "Foreign Person"is a nonresident alien individual,foreign corporation,foreign partnership,foreign trust,or foreign estate.The"Amount Realized"is the awn <br /> of the cash paid,the fair market value of other property transferred,and the amount of any liability assumed by a transferee. <br /> Under IRC Section 1445(bX2)a transaction is exempt from the withholding if the transferor furnishes to the transferee an affidavit by the transferor stating, <br /> under penalty of perjury,the transfer's United State taxpayer identification number and that the transferor is not a foreign person. <br /> Under IRC Section 1445(bX9),as an alternative,the exemption under IRC 1445(bX2)shall be treated as applying to a transaction if,in connection with a <br /> disposition of a United States real property interest:(i)the affidavit specified in IRC 1445(bX2)is furnished to a qualified substitute,and(ii)the qualified <br /> substitute furnishes a statement to the transferee stating,under penalty of perjury,that the qualified substitute has such affidavit in its possession. <br /> Under IRC Section 1445(fX6)A qualified substitute is defined as the person(including any attorney or title company)responsible for closing the transaction, <br /> other than the seller's agent,and the buyer's agent. .".a <br />