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Instrument Control Number 0 0 8 2 s f
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Commonwealth of Virginia II��IIIIIIIIII1111111111111.{l{IIti 1111111111IfluIIlUI1l11lINIll�111111111
Land Record Instruments
Cover Sheet- Form A Doc ID: 06/12/260011 Type: D21
Recorded: 06/12/2013 at 10:42:21 AM
Fee Act: $61.00 Pape i of 11
Albemarle County VA
[ILS VLR Cover Sheet Agent 1.0.66] Debra M. Shipp Clerk
File# 2013-00008251
✓ c Date of Instrument: [6/6/2013 ] BK4365PG35-45
A 0 Instrument Type: [DEC ]
X R
P
E Number of Parcels [ 2]
X Number of Pages [ 6)
E .
for Deed Stamp Only) '
M CityI .1 County x [Albemarle County ]
P . ,First and Second Grantors _.. ._._._.___._._..
T Suffix
T 1. Last Name ,.. _.._-_._ First Name_ -._.__I Middle Name or initial
x [Martha Jefferson Hospital[ ][ ][ ]
11 1 [ ][ ]I 1[ ]
_ First and_Second Grantees _. . ._..— _ ._._.
Las_t Name ...... .._,.,__ First Name _ r _Middle Name or initial _..,,� _...._..Suffix
Ill1 [ It It ]I ]
Grantee Address (Name) [N/A ]
(Address 1) [N/A ]
(Address 2) [ ]
(City,State,Zip) [N/A ] [VA] [N/A ]
Consideration[0.00 ]Existing Debt[0.00 ] Assumption Balance [0.00 ]
Prior Instr. Recorded at: City 1 I County Ix! [Albemarle County ] Percent.in this Juris. [ 100]
Book [276 ] Page [407 ] Instr.No [ ]
Parcel Identification No(PIN) [06100-00-00-12000 ]
Tax Map Num, (If different than PIN) [06100-00-00-12000 ]
Short Property Description [SEE INSTRUMENT ]
I ] I
Current Property Address (Address 1) [ ]
(Address 2) [
(City,State,Zip) [ ] I I[ ]
Instrument Prepared by [Williams Mullen ] 1'
Recording Paid for by [Williams Mullen ]
Return Recording to (Name) [Valerie W Long Esq ]
(Address 1) [Williams Mullen ]
(Address 2) [321 East Main Street Suite 400 ]
(City,State,Zip) [Charlottesviie I [VA][22902 ]
Customer Case ID [ ] [ ] [ ]
Cover Sheet Page#1 of 2 11111111M
1
(Page 2 of 11) - The image is too larger for printed page!
New Noire
Instrument Control Number
Commonwealth of Virginia
Land Record Instruments
Continuation Cover Sheet
Form C
(ILS VLR Cover Sheet Agent 1.0.68]
T G G C
Date of Instrument: [6/6/2013 ]
A R R'. 0 Instrument Type: [DEC ]
X A A' R
E T T 'P Number of Parcels [ 2]
X 0 E . Number of Pages [ 6]
E R E i x� (Box for Deed Stamp Only)
M City I �County!. [Albemarle County ]
P Grantors/Grantees/Parcel Continuation Form C
T I I - Last Name 1_ —_First Name ...._ .
Middle Name or Initial n1.._.-Suffix. —i
r1lIF-11-I [ ]t ]] ]I ]
r-.1IAL..1LJ [ ][ It ] [ ]
71 11 -1 . 1 t ][ ][ ] I ]
x-.11._ 11., 1 1 [ ][ ][ ]t ]
H1.11 ' I .1 t 31 l ][ ]
Prior Instr.Recorded at: city Li County C [ ] Percent.in this Juris. [ 100]
Book [ ] Page [ ] Instr. No [ ]
Parcel Identification No(PIN) [06100-00-00-120K0 ]
Tax Map Num. (If different than PIN) [06100-00-00-120K0 ]
Short Property Description [SEE INSTRUMENT ]
[ ]
Current Property Address (Address 1) [ ]
(Address 2) [ ]
(City,State,Zip) [ ][ ][ ]
Prior Instr.Recorded at:City — County Li [ ] Percent. in this Juris. [ ]
Book [ ] Page [ ] Instr. No [ ]
Parcel identification No(PIN) [ )
Tax Map Num. (if different than PIN) [ )
Short Property Description [ ]
[ ]
Current Property Address (Address 1) [ )
(Address 2) [ ]
(City,State,Zip) [ ][ ][ 3
11111M
Cover Sheet Page#2 of 2