Backup Documents 05/24/2016 Item #16K2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO L ORIGINAL DOCUMENTS SENT TO Pf
THE BOARD OF COUNTYCOMMISSIONERS OFFICE FOR SIGNATURE 16
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s)(List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office JAB 5/27/16
4. BCC Office Board of County
Commissioners \114-‘76.1/4) '5\,--\\k:)
5. Minutes and Records Clerk of Court's Office
SIM-)
a:t/SPt
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff Jennifer Belpedio,Assistant County 252-8400
Contact/Department Attorney
Agenda Date Item was 5/24/16 Agenda Item Number 16-K-2
Approved by the BCC
Type of Document Application for Tax Deed Number of Original 4
Attached Documents Attached
PO number or account n/a
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes I N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature STAMP OK JAB
2. Does the document need to be sent to another agency for additional signatures? If yes, JAB
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JAB
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's JAB
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the JAB
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's JAB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JAB
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 5/24/16 and all changes made during the JAB
meeting have been incorporated in the attached document. The County Attorney's
Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready for the
Chairman's signature.
PLEA - • - - i „ ; •• -i' ; '_ AL 4 : : ' ,.'
UP ``('‘\C.-)`1-0
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
1 6 K
MEMORANDUM
Date: May 27, 2016
To: Dinny Neet, Paralegal/Legal Assistant
County Attorney's Office
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Application for Tax Deeds
Attached for your records are the original documents referenced above, (Item #16K2)
adopted by the Board of County Commissioners on Tuesday, May 24, 2016.
The original Resolution will be held in the Minutes and Records Department for
the Board's Official Record.
If you have any questions, please call me at 252-7240.
Thank you.
Attachment
APPLICATION FOR TAX DEED iR.04/16
LP r,,r 4,.)
5i�2t
ri Rule 12D-16.002
Section 197.502, Florida Statutes F.A.C.
Eff.04/16
FLORIDA
To: Tax Collector of Collier County, Florida
I, Collier County , hold the listed
certificates tax and submit them to the tax collector.
Certificate Number Date Legal Description
# 10-10606 5/30/2014 4 52 28 A PARCEL OF LAND IN THE SE1/4 AS DESC IN OR 3844 PG
2978 AND REFERENCED AS PARCEL"B"
# 11-8671 5/31/2014 4 52 28 A PARCEL OF LAND IN THE SE1/4 AS DESC IN OR 3844 PG
2978 AND REFERENCED AS PARCEL"B"
# 12-7017 5/30/2014
4 52 28 A PARCEL OF LAND IN THE SE1/4 AS DESC IN OR 3844 PG
2978 AND REFERENCED AS PARCEL"B" _ 1
#13-6527 5/30/2014 4 52 28 A PARCEL OF LAND IN THE SE1/4 AS DESC IN OR 3844 PG
2978 AND REFERENCED AS PARCEL"B"
# 14-5805 5/30/2014 4 52 28 A PARCEL OF LAND IN THE SE1/4 AS DESC IN OR 3844 PG
2978 AND REFERENCED AS PARCEL"B"
#
I agree to:
• pay all delinquent taxes,
• redeem all outstanding tax certificates plus interest, and
• pay any delinquent, omitted, or current taxes and interest covering the property.
I agree to pay all tax collector's fees, ownership and encumbrance report costs, clerk of the court costs, charges and
fees and sheriff' -.•sts, if appli le. Attached is the tax certificate on which this application is based, and all other
certificates oft :me legal de ripti n, which are in my possession.
i ` / 5/24/2016
Applicant's signature Date
Approved as to form and legality
DIV HT 1=,13R Ks Clerk
- Lwr Assistant Coun omey
Attest 4S to Chairman's S 12Lhx(e)
signature only.
1 6 K 2
DR-512
111 APPLICATION FOR TAX DEED R-04/16
Section 197.502, Florida Statutes Rule 12D-16.002
F.A.C.
Eff.04/16
FLORIDA
To: Tax Collector of Collier County, Florida
I, Collier County , hold the listed
certificates tax and submit them to the tax collector.
Certificate Number Date Legal Description
4 47 29 BEG AT SE CNR OF SW1/4 OF SE1/4 OF SE1/4, RUN N ALG E
#13-0241 5/30/2013 BDRY 150FT, S 88DEG W 30FT TO POB, W 75FT, N 31.3FT, E 75FT, S
31.3FT TO POB OR 2041 PG 1896
4 47 29 BEG AT SE CNR OF SW1/4 OF SE1/4 OF SE1/4, RUN N ALG E
# 15-0200 5/28/2015 BDRY 150FT, S 88DEG W 30FT TO POB, W 75FT, N 31.3FT, E 75FT, S
31.3FT TO POB OR 2041 PG 1896
# 1
#
#
I agree to:
• pay all delinquent taxes,
• redeem all outstanding tax certificates plus interest, and
• pay any delinquent, omitted, or current taxes and interest covering the property.
I agree to pay all ttkplelector's fees, ownership and encumbrance report costs, clerk of the court costs, charges and
fees and sheriffs if applica,le.Attached is the tax certificate on which this application is based, and all other
certificates of thlegal deipti• , which are in my possession.
5/24/2016
1.
Applicant's signature Date
D'ilx 1i E.. aao . Mink Approved as to form and legality
:w d►_ •
_ .
.wu.., , Assistant County A . , y
Attest as to hairman's
161( 2
ri APPLICATION FOR TAX DEED DR-512
R.04/16
Rule 12D-16.002
I Section 197.502, Florida Statutes F.A.C.
Eff.04/16
FLORIDA
To: Tax Collector of Collier County, Florida
I, Collier County , hold the listed
certificates tax and submit them to the tax collector.
Certificate Number Date Legal Description
# 13-1047 5/30/2013 11 52 32 25% 0 G& M RIGHTS DESC AS: NE1/4 NW1/4 40 AC OR 293
PG 8
I agree to:
• pay all delinquent taxes,
• redeem all outstanding tax certificates plus interest, and
• pay any delinquent, omitted, or current taxes and interest covering the property.
I agree to pay all tax collector's fees, ownership and encumbrance report costs, clerk of the court costs, charges and
fees and sheriff osts, if applic-ble. Attached is the tax certificate on which this application is based, and all other
certificates of t • -=me legal d: cription, which are in my possession.
1 5/24/2016
Applicant's signature Date
approved as to form and legality
� b .
t
ant County AOA ssis y
R- tay\k(4
' '4'-.° .3 ._,'_i(.iaF4{ultidit S
r L i4i :`.
;art; attire only.
APPLICATION FOR TAX DEED R /16
Section 197.502, Florida Statutes Rule 12D-16.002
F.A.C.
Eff.04/16
FLORIDA
To: Tax Collector of Collier County, Florida
I, Collier County , hold the listed
certificates tax and submit them to the tax collector.
Certificate Number Date Legal Description
#09-11570 5/30/2014 GOLDEN GATE ESTATES UNIT 72 E 180FT OF TR 55
I agree to:
• pay all delinquent taxes,
• redeem all outstanding tax certificates plus interest, and
• pay any delinquent, omitted, or current taxes and interest covering the property.
I agree to pay all tax collector's fees, ownership and encumbrance report costs, clerk of the court costs, charges and
fees and sheriff osts, if appli able. Attached is the tax certificate on which this application is based, and all other
certificates oft ame legal d cription, which are in my possession.
5/24/2016
Applicant's signature Date
Ta Approved as to form and legality
As' tant County me
y
• ;u 2S 10 Chairman's 5 Vg,