Docket Number:____________________
(office use only)
Section 1 – Recent Sale Data
The following information regarding the sale of the subject property if furnished to the Board of Review to render a decision based
on the evidence provided by the appellant. You should submit evidence of the arm’s length transaction by including sales contract,
Real Estate Settlement Procedures Act (RESPA) statement, Real Estate Transfer Declaration (RETD) or settlement statement.
Full consideration (sale price): ________________________________________________
From whom purchased: _____________________________________________________
Date of sale: ______________________________________________________________
Is the sale a transfer between family or related corporations?
_______yes
_______no
Sold by _______Owner _______ Agent _______ Auction _______ Other
Name of real estate agency ________________________________ Agent _______________________
Was the property advertised for sale? _______yes _______no
How long a period? ____________
If advertised, in what manner? _______local paper _______multiple listing ________________other?
Was the property sale in settlement of _______ an installment contract
_______contract for deed?
Was the property sale in settlement of _______ a foreclosure?
Was the Seller’s mortgage assumed?
_______yes _______no $___________ If yes, specify amount.
If renovated, amount spent before occupying $________________ Date occupied ________________
Provide recent photograph of subject property.
Section 2 – Recent Construction Data
Submit evidence of recent construction of the subject property including the price paid for the land and construction of the building
improvements including all labor. Note: If the appellant provided any labor or acted in the capacity as general contractor, evidence
of the value of this service should be included with the evidence of the construction costs.
The building improvement was constructed, or remodeled, an addition added on _________________
Date of land purchase _________________________________________________________________
Total cost of land $_______________________ Building improvements $_______________________
Does this amount include all costs incurred for construction, such as contractor’s fees, architectural or
engineering fees, landscaping and/or building permits. _______yes
_______no
If yes, what is the estimated amount of the services and/or fees?
$_______________________
Date certificate of completion or occupancy permit was issued (provide copy) ____________________
Date the building improvement was inhabitable and fit for occupancy or intended use ______________
Date the addition or other building improvement was completed _______________________________
Note: Provide a contractor’s affidavit or documentation of the total costs to the Board of Review.
Provide recent photograph of subject property.
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