Irs Form 1099-S - Certification Exemption Form (Page 2 of 2) in pdf

Irs Form 1099-S - Certification Exemption Form Page 2

residence during the 2-year period ending on the date of the sale or exchange of the residence.

[ ]

(5) During the 5-year period ending on the date of the sale or exchange of the residence, I did not acquire the

residence in and exchange to which section 1031 of the Internal Revenue Code applied.

T F N/A

[ ] [ ] [ ] (6) If my basis in the residence is determined by reference to the basis in the hands of a person who acquired

the residence in an exchange to which section 1031 of the Internal Revenue Code applied, the exchange to

which section 1031 applied occurred more than 5 years prior to the date I sold or exchanged the

residence.

Part III. Seller Certification

Under penalties of perjury, I certify that all the above information is true as of the end of the day of the sale or

exchange.

Signature of Seller

Date

ORT Form 3956 (Rev. 1/22/07)

Irs Form 1099-S - Certification Exemption Form Page 2