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Real Property Conveyance Fee Statement Of Value And Receipt DTE 100 - Ohio
| Real Property Conveyance Fee Statement Of Value And Receipt Form. This is a Ohio form and can be used in Revaluation Statewide . |
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DTE FORM 100 (REV 12/98) REAL PROPERTY CONVEYANCE FEE STATEMENT OF VALUE AND RECEIPT If exempt by O.R.C. 31954(F)(3), Use DTE Form 100 (EX) FOR COUNTY AUDITOR'S USE ONLY Type Instrument Property Located in Name on Tax Duplicate Acct. or Permanent Parcel No. Description: AUDITOR'S COMMENTS: Tax Duplicate Year Map Book Page No. of Parcels Tax List Year County Number Tax Dist. Number Date Taxing District Number Platted Split C.A.U.V. Unplatted DTE Code No. New Plat New Improvements Partial Value Building Removed Other GRANTEE OR REPRESENTATIVE MUST COMPLETE ALL QUESTIONS IN THIS SECTION TYPE OR PRINT ALL INFORMATION SEE INSTRUCTIONS ON NEXT PAGE Neigh. Code 1. Grantor's Name Phone: 2. Grantee's Name Phone: Grantee's Address 3. Address of Property 4. Tax Billing Address 5. Are there buildings on the land? YES NO If yes check type: 1, 2 or 3 Family Dwlg. Condominium Apartment: No. of Units Manufactured (mobile) home Farm buildings Other If land is vacant, what is intended use? 6. Conditions of Sale (Check all that apply:) Grantor is Relative Part Interest Transfer Trade Life Estate Leased Fee Leasehold Mineral Rights Reserved Grantor is Mortgagee Other: 7. a) New Mortgage Amount (If any) ............................................................................................ $ b) Balance Assumed (If any) ..................................................................................................... $ c) Cash (If any) .......................................................................................................................... $ d) Total Consideration (Add Lines 7a, 7b and 7c) ..................................................................... $ e) Portion, if any, of total consideration paid for items other than real property ....................... $ f) Consideration for real property on which fee is to be paid (7d minus 7e).............................. $ g) Name of Mortgagee No. of Acres Land Value Land Contract Gift Bldg. Value Total Value 0.00 0.00 DTE Use Only h) Type of Mortgage Conv. F.H.A. V.A. Other: DTE Use Only i) If gift, in whole or part, estimated market value of the real property ..................................... $ 8. Has the grantor indicated that this property is entitled to receive the senior citizen, disabled person, or YES NO. If yes, surviving spouse homestead exemption for the preceding or current tax year? complete DTE 101. 9. Has the grantor indicated that this property qualified for current agricultural use valuation for the preceding or current tax year? YES NO. If yes, complete DTE Form 102. 10. Application For 2 1/2% Reduction (NOTICE: failure to complete this application prohibits the owner from receiving this reduction until another proper and timely application is filed): Will this property be grantees principal residence by January 1 of next year? YES NO. If yes, is the property a multi-unit dwelling? YES NO. I DECLARE UNDER PENALTIES OF PERJURY THAT THIS STATEMENT HAS BEEN EXAMINED BY ME AND TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS A TRUE, CORRECT AND COMPLETE STATEMENT. SIGNATURE of GRANTEE or REPRESENTATIVE DATE DTE Use Only Consideration DTE Use Only Valid Sale 1. YES 2. NO RECEIPT FOR PAYMENT OF CONVEYANCE FEE The conveyance fee required by section 319.54(F)(3) R.C., and , if applicable, the fee required by Chapter 322 R.C., in the total amount of $ has been paid by and received by the County Auditor. COUNTY AUDITOR DATE American LegalNet, Inc. www.FormsWorkFlow.com
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