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Confirmation of Real Property Sale <br /> 1111111111111111111111 523605 <br /> Rural Seller: $1,025,000.00 <br /> ROTH,JAMES D& ROTH, DEBRA L 1011111111M1111111111516/30/2020 <br /> 1650 95TH AV NE 072W240000600 <br /> SALEM,OR 97317 0406000 551 <br /> 1.Total sales price: $ /(5 cre7-1 �Oti <br /> agreed upon: .5-— Q J�'C� <br /> 2.Date sales price was g p SSC. GO ,g, <br /> 3.Did this transaction involve any of the following?Please check all that apply. <br /> ❑buyer owns adjoining property ❑ <br /> estate sale 0 partial interest conveyed 0 trade or exchange 0 auction <br /> ❑distress sale ❑buyer or seller a charitable organization 0 buyer and seller related by business or family <br /> 4. If the buyer paid any back taxes(not just your share of the current year taxes)or special assessments in addition to the sale price, <br /> please state the amount: $ <br /> 5.Were any of the following included in the sales price entered in question 1?Please check all that apply. <br /> ❑equipment/machinery 0 livestock 0 crops/timber ❑ mobile home 0 furniture <br /> ❑other: <br /> Total value,known or estimated,of all items checked: $ <br /> 6. Was the property listed on the open market(real estate broker,online,newspaper,etc.)at the time of purchase? <br /> ❑yes (�no ❑don't know <br /> 7.Vacant land transaction only:Were any of the following on site at time of purchase?Please check all that apply. <br /> ❑electric service ❑water/well 0 sewer/septic 0 mobile home pad 0 pavement 0 curbs/gutters <br /> other improvements or structures <br /> If not already on site at time of transaction,has approval for a septic tank been granted? ❑yes ❑ no <br /> 8.If farmland,is land rented? 0 yes 0 no <br /> If"yes",number of acres rented: _ _ Rent per acre per year: $ <br /> 9.Your opinion of condition of the structures at time of sale: ❑ poor 0 fair ❑ average ❑good Kexcellent <br /> Please describe if"poor"or"fair": — <br /> Your Name: j I VII\ 1)--6'i <br /> p � Email: IA,. re � � 1� "AzAz-r �� <br /> Phone#: 51 -2O 5 6 (J <br /> A county appraiser may contact you for additional details or clarification.Thank you! <br />