Dte Form 101 - Statement Of Conveyance Of Homestead Property

DTE FORM 101

Alan Harold

Kim R. Perez

Revised 10/99

Stark County Auditor

110 Central Plaza South, Suite 220

Canton, OH 44702

STATEMENT OF CONVEYANCE OF HOMESTEAD PROPERTY

To be attached to Conveyance Fee Forms, DTE 100, 100(EX), 100M & 100(EX)

Grantor’s (Seller’s) Name __________________________________________________________________

Grantor’s Address ________________________________________________________________________

Grantee’s (Buyer’s) Name __________________________________________________________________

Taxing District ___________________________________________________________________________

Parcel, Account or Registration No. ___________________________________________________________

Complete This Section Only If Real Estate Is Transferred

The grantor of the property referred to above states that the property has or will receive the senior citizen,

disabled persons, or surviving spouse homestead exemption under Ohio Revised Code Section 323.152 (A)

for the preceding or current tax year. The estimated amount of such reduction that will be reflected in the

grantee’s taxes is:

Preceding Tax Year $______________

Current Tax Year $_________________

Complete This Section Only If Manufactured or Mobile Home Is Transferred

The grantor of the manufactured or mobile home referred to above states that the home received the senior

citizen, disabled persons or surviving spouse homestead exemption under the Ohio Revised Code Section

4503.065 for the current tax year. The estimated amount of such reduction that will be reflected I the grantee’s

taxes is $__________________________________.

The grantor and the grantee have considered and accounted for the total estimated amount of such

reduction(s) to the satisfaction of both the grantee and the grantor.

________________________________________

Signature of Grantor or Representative

Sworn to or affirmed in my presence, this ______ day of ________________________ ____________(year).

____________________________

Notary Public

________________________________________________________________________________________

FOR OFFICE USE ONLY

Endorsement by County Auditor:

Upon presentation of this instrument, the County Auditor shall indorse it, return it to the grantee or his

representative, and provide a copy of the indorsed instrument to the grantor or his representative, evidencing

delivery to the County Auditor.

ALAN HAROLD

County Auditor: KIM R. PEREZ

Deputy Auditor: ________________________ Date: _______________

Dte Form 101 - Statement Of Conveyance Of Homestead Property - 1999