3988 ATT04 - TransferLRO # 41 Transfer REGISTERED PReceited as C0178648 on 2018 01 26 at 16:21
The applicant(s) hereby applies to the Land Registrar. yyyy mm dd Page 1 of 3
IProperties
PIN 00026-0755 LT Interest/Estate Fee Simple
Description LOT 74, PLAN 41 M137. TILLSONBURG
Address TILLSONBURG
IConsideration
Consideration $2.00
ITransferor(s)
The transferor(s) hereby transfers the land to the transferee(s).
Name HER MAJESTY THE QUEEN IN RIGHT OF ONTARIO AS REPRESENTED BY THE MINISTER OF
INFRASTRUCTURE
Address for Service c/o Infrastructure Ontario
777 Bay Street, Suite 900
Toronto, ON M5G 2C8
Attention: Legal Services
This document is not authorized under Power of Attorney by this party.
This document is being authorized by a representative of the Crown.
ITransferee(s) Capacity Share
Name THE CORPORATION OF THE TOWN OF
TILLSONBURG
Address for Service 200 Broadway, 2nd Floor, Suite 204
Tillsonburg, ON N4G 5A7
IStatements I
The land is being acquired or disposed of by the Crown in Right of Ontario or the Crown in Right of Canada, including any Crown
corporation, or any agency, board or commission of the Crown; or a municipal corporation.
ISigned By
Elizabeth Agbi 777 Bay Street Suite 900 acting for Signed 201801 26
Toronto Transferor(s)
M5G 2C8
Tel 416-327-1738
Fax 416-326-2654
1 have the authority to sign and register the document on behalf of the Transferor(s).
Patrick Joseph Kraemer 45 Erb St. East, box 457 acting for
Waterloo Transferee(s)
N2J 4135
Tel 519-886-3340
Fax 519-886-8651
1 have the authority to sign and register the document on behalf of the Transferee(s).
ISubmitted By
DUNCAN, LINTON LLP
Tel 519-886-3340
Fax 519-886-8651
IFees/Taxes/Payment
Statutory Registration Fee
Provincial Land Transfer Tax
45 Erb St. East, box 457
Waterloo
N2J 4135
63.65
0.00
Signed 201801 26
1
201801 26
LRO # 41 Transfer Receipted as C01 78648 on 2018 01 26 at 16:21
The applicant(s) hereby applies to the Land Registrar.
IFees/faxes/Payment
Total Paid
IFile Number
Transferor Client File Number
Transferee Client File Number
63.65
ESCH-0489 - TOWN OF TILLSONBURG
0040323
yyyy mm dd Page 2 of 3
LAND TRANSFER TAX STATEMENTS
In the matter of the conveyance of: 00026-0755 LOT 74, PLAN 41M137. TILLSONBURG
BY: HER MAJESTY THE QUEEN IN RIGHT OF ONTARIO AS REPRESENTED BY THE MINISTER OF INFRASTRUCTURE
TO: THE CORPORATION OF THE TOWN OF TILLSONBURG
1. STEPHEN MOLNAR, MAYOR AND DONNA WILSON CLERK
lam
a) A person in trust for whom the land conveyed in the above-described conveyance is being conveyed;
b) A trustee named in the above-described conveyance to whom the land is being conveyed;
c) A transferee named in the above-described conveyance;
d) The authorized agent or solicitor acting in this transaction for THE CORPORATION OF THE TOWN OF
TILLSONBURG described in paragraph(s) (c) above.
e) The President, Vice -President, Manager, Secretary, Director, or Treasurer authorized to act for
described in paragraph(s) (_) above.
f) A transferee described in paragraph (_) and am making these statements on my own behalf and on behalf
of who is my spouse described in paragraph (_) and as such, I have personal knowledge of the facts
herein deposed to.
3. The total consideration for this transaction is allocated as follows:
4
a) Monies paid or to be paid in cash 2.00
b) Mortgages (i) assumed (show principal and interest to be credited against purchase price) 0.00
ii) Given Back to Vendor 0.00
c) Property transferred in exchange (detail below) 0.00
d) Fair market value of the land(s) 0.00
e) Liens, legacies, annuities and maintenance charges to which transfer is subject 0.00
f) Other valuable consideration subject to land transfer tax (detail below) 0.00
g) Value of land, building, fixtures and goodwill subject to land transfer tax (total of (a) to (f)) 2.00
h) VALUE OF ALL CHATTELS -items of tangible personal property 0.00
i) Other considerations for transaction not included in (g) or (h) above 0.00
j) Total consideration 2.00
Explanation for nominal considerations:
g) Transfer to a municipality pursuant to subdivision or development agreement, condominium approval or other municipal
purposes: road widening
5. The land is not subject to an encumbrance
6. Other remarks and explanations, if necessary.
1. The information prescribed for purposes of section 5.0.1 of the Land Transfer Tax Act is not required to be provided for this
conveyance.
2. The transferee(s) has read and considered the definitions of "designated land", "foreign corporation", "foreign entity", "foreign
national" "specified region" and "taxable trustee" as set out in subsection 1(1) of the Land Transfer Tax Act. The transferee(s)
declare that this conveyance is not subject to additional tax as set out in subsection 2(2.1) of the Act because:
3. (b) This is not a conveyance of "designated land".
4. The transferee(s) declare that they will keep at their place of residence in Ontario (or at their principal place of business in
Ontario) such documents, records and accounts in such form and containing such information as will enable an accurate
determination of the taxes payable under the Land Transfer Tax Act for a period of at least seven years.
5. The transferee(s) agree that they or the designated custodian will provide such documents, records and accounts in such
form and containing such information as will enable an accurate determination of the taxes payable under the Land Transfer
Tax Act, to the Ministry of Finance upon request.
PROPERTY Information Record
A. Nature of Instrument: Transfer
LRO 41 Registration No. C0178648 Date: 2018/01/26
B. Property(s): PIN 00026 - 0755 Address TILLSONBURG Assessment -
Roll No
C. Address for Service: 200 Broadway, 2nd Floor, Suite 204
Tillsonburg, ON N4G 5A7
D. (i) Last Conveyance(s): PIN 00026 - 0755 Registration No. LT30368
ii) Legal Description for Property Conveyed: Same as in last conveyance? Yes No Not known
E. Tax Statements Prepared By: Patrick Joseph Kraemer
45 Erb St. East, box 457
Waterloo N2J 4135