Illinois Real Estate Transfer Declaration
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1
2/T':
PTAX-203
\ j
Illinois Real Estate
ci
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read
!~:~r:!t:~s ~~:~:~~~!!i~g~his
form.
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1015R13075
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Step
1:
Identify the property and sale information.
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y
REC ON: 07/15/2015 2:30:06 PM
CHAMPA!GN COUNTY
1
79.76 ACRES NE l/4 S26
Tl f:.J
St,<;e\ e::!:iress of property (ur 91 i adciress, if a·_,aiie:ble)
PE?OTut-1
Ci!y
or v;IIG\;le
PESOTUt-1
To·.r;;r.shp
?.3E
61853
ZIP
2
Write the tatal number of parcels to be transferred. ___ 1
3
VIJrlte the parcel identifying numbers and Jot sizes or acreage.
Property index number {PIN)
Lot size cr acreage
a lR-32-26-200-00l
]9. 76
ACRES
b _ _ _ _ _ _ _
c _ _ _ _ _ _ _ _ _ _ _ _ _
d _ _ _ _ _ _ _ _ _ _ ___
VVrite additional prcperty index numbers, lot sizes or acreage in
Step 3.
4
Date of instrument:
0
7
I
2
0
1
5
Month - -
YC3f - - - - - -
5
Type of instrument
{Mark
with an";.::·}:
_ _ Wnrranty deed
Quit ciaim deed _ _ Executor deed
......L
Trustee
deed
__ BenGfid31 interest ___
Other
(s~ecify):
____________ _
6
~--Yes
_li._
No Wiil the property be lht: buyer's principal residence?
7
· __
Yes
_x_
No V.Jas
the
property advertised
lor
sale?
}
(i.e.,
media,
sig11,
newspa!Jer, realtor)
8
1dentify
the property's
current and intended
primary
use.
Currer.t 1nlended
(Mark only one item per column ·.·.-ith an "X."")
a__
__ Land/lot only
b _ _
_ _
Residence
(s·ngiu·fa;nily, ccnGcm!n!um, townhcr:.c. vr
dup!ec-:1
c__ __
Mcbile home residence
d___
_ __ Apmtment building
{6
uniis
{Y
rc:o:o)
No.
of
units:
c
_ _
Apartment building
(ovRr 6 um!s)
No. of unit:;:
Office
g__
__ Retail establishment
h
_ _ Commercial building
(speCify): _ _ _ _ _ _ _ _ _
_ _ lr.dus!rial building
j __
_x_
__6_
Farm
k
__ Other
(spcsify;:
Step
2:
Calculate the amount of transfer tax due.
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tit:coxr,-r;~K
REC FEE:: 44.GO
RHSPS Fcc: 9.00
REV FEE: 1355.25
PAGES 2
PLAT ACT: OPLAT PAGE:
9 Identify any significant
physical
changes In the
pro;:erty
since
January 1 of the
previous
year and write the date of the change.
Dale of significant change: _ _ _ _ ' _ _ _ _ _ _ _ _
~~-~::!rh ·::~~!1
an "X.")
Month
w~ar
__ Demolition/C.::uno.ge
~--
Add;tivns __ Major
rerr;ode!ing
New
constructlon
__ Other
(spt:.:.·';•::
10 Identify only the items
thc;_t apply
to this
sale.
(MRrh .,..,;han "X."J
a __ Fulfillment of installment contract-
year
contract initiated:-------·
b
_x_
Sale between related
individuals
or
corporate affiliates
c _ _
Transfer
of less
than 100
percent inteiest
d
Court-ordered sale
e
Saie in
lieu of
foreclosure
Condemnat:on
9 __
Short
sa1e
h __ Bank REO (real estate owned)
i __ Auction
sale
j ____
Seller/buyer
is a
relocation company
k _ _
Seller/buyer
is a financial institution
or
government agency
I __ Buyer is a real estate investment trust
m __
Buyer
is a pension
tur~~::J
n __ Buyer
is an adjacent property owner
o __ Buyer is
exercising an option to purchase
p __
Trade of property (simultaneous)
q __ Sale-leaseback
r __ Other
(spee>ly): - - - - - - - - - - - - - - - -
s _ _
Homestead
exemptions on most
recent
tax bill:
1 Generai/AIIernative
~
0. 0 0
2
Senior Citizens
S
0 . 0 0
3 Senior Citizens Assessment Freeze
$
__
0 • 0 G
Note: Round Lines 11 through 18 to the next
highest
·::hole
dollar.
If
the
amount an Line 11 is over S1 million and the property's current use on Une 8
above is marked "e,"
"!," "g," "h," "i," or ';k," complete Fcrm PTAX-203-A, l!lino's Real Estate Transfer Declaration Supplemental Form A. If you are record-
:ng a beneficial interest transfer, do not cornr!ete this step.
Comp!t::TP.
Fon11 PTAX-203-B, liiinois Real Estate Transfer Declaration
Supplemental
Form B.
11
Fullactualconsideration
11
$
903 ?R2.00
12a
Amount of personal property included in the purchase
12a
$
0 . 0
Q
12b
Was the value of a mobile home included on Line 12a
7
12b
__
Yes
_x__
No
13
Subtract Line 12a
I
rom Line 11. This is the net consideration for real property.
13
S
9 0 3 2 8 2 . 0 0
14
Amount for other real property transferred to the seller (in a simultaneous exchange)
as part of the full actual consideration on Line 11
15
Outstanding mortgage amount to which
the transferred real
property remains subject
} If
this transfer is
exempt,
use an "X"
to
identify the provision.
1/
Subtract
Lines
14 and 15 from Line 13. This is the net
consideration subject
to
transfer
tax.
18
Divide Line 17
by
500. Round the result to the next highest whole number
{e.g. 61.002
rounds to
62).
19
Illinois tax slamps- multiply Line 18 by 0.50.
20
County tax stamps- multiply Line 1 8
by
0.25.
21
Add Lines 19 and 20.
This is
the total amount oftransfer tax due.
~·
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1-t_''~.-';:,r,i::~:..-~u~'~'-'!L.'::'~ '._"_'-_'-i:~':':.n::~~~~~._~~~~ ~~-~,0~-:~_:!..S.~_fJ.:_~:~.c;?:~.r-e_
of !h},S
i~!~r~~!'~n
I
14
15
16
17
18
19
20
21
$
0.00
s
0.00
b
k
m
---
- -
- -
s
903 282.0Q
1 807.00
s
903.50
$
451.75
$
1.355.25
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