PTAX-203 Do not write in this area. County Recorder's Office use. Illinois Real Estate Transfer Declaration Please read the instructions before completing this form. This form can be completed electronically at tax.illinois.gov/retd. County: Date: Doc. No.: Vol.: Page: Received by: Step 1: Identify the property and sale information. 1 ____________________________________________________ Street address of property (or 911 address, if available) ____________________________________________________ City or village ZIP ____________________________________________________ Township 2 Write the total number of parcels to be transferred. ___________ 3 Write the parcel identifying numbers and lot sizes or acreage. Property index number (PIN) Lot size or acreage a_____________________________ ___________________ b_____________________________ ___________________ c_____________________________ ___________________ d_____________________________ ___________________ Write additional property index numbers, lot sizes or acreage in Step 3. 4 Date of instrument: ____ ____ / ____ ____ ____ ____ 9 Identify any significant physical changes in the property since January 1 of the previous year and write the date of the change. Date of significant change: ____ ____ / ____ ____ ____ ____ (Mark with an "X.") Month Year 5 6 7 8 ____ Demolition/damage ____ Additions ____ Major remodeling ____ New construction ____ Other (specify): ________________ 10 Identify only the items that apply to this sale. (Mark with an "X.") a ____ Fulfillment of installment contract -- year contract initiated : ___ ____ ____ ____ b ____ Sale between related individuals or corporate affiliates c ____ Transfer of less than 100 percent interest Month Year d ____ Court-ordered sale Type of instrument (Mark with an "X." ): _____ Warranty deed e ____ Sale in lieu of foreclosure ____ Quit claim deed _____ Executor deed ____ Trustee deed f ____ Condemnation ____ Beneficial interest _____ Other (specify):______________ g ____ Short sale ____ Yes ____ No Will the property be the buyer's principal residence? h ____ Bank REO (real estate owned) ____ Yes ____ No Was the property advertised for sale? i ____ Auction sale (i.e., media, sign, newspaper, realtor) j ____ Seller/buyer is a relocation company Identify the property's current and intended primary use. k ____ Seller/buyer is a financial institution or government agency Current Intended (Mark only one item per column with an "X.") l ____ Buyer is a real estate investment trust a ____ ____ Land/lot only m ____ Buyer is a pension fund b ____ ____ Residence (single-family, condominium, townhome, or duplex) n ____ Buyer is an adjacent property owner c ____ ____ Mobile home residence o ____ Buyer is exercising an option to purchase d ____ ____ Apartment building (6 units or less) No. of units: _______ p ____ Trade of property (simultaneous) e ____ ____ Apartment building (over 6 units) No. of units: _______ q ____ Sale-leaseback f ____ ____ Office r ____ Other (specify): __________________________________ g ____ ____ Retail establishment __________________________________________________ h ____ ____ Commercial building (specify): _________________ s ____ Homestead exemptions on most recent tax bill: i ____ ____ Industrial building 1 General/Alternative $______________ j ____ ____ Farm 2 Senior Citizens $______________ k ____ ____ Other (specify): ____________________________ __ 3 Senior Citizens Assessment Freeze $______________ Step 2: Calculate the amount of transfer tax due. Note: Round Lines 11 through 18 to the next highest whole dollar. If the amount on Line 11 is over $1 million and the property's current use on Line 8 above is marked "e," "f," "g," "h," "i," or "k," complete Form PTAX-203-A, Illinois Real Estate Transfer Declaration Supplemental Form A. If you are recording a beneficial interest transfer, do not complete this step. Complete Form PTAX-203-B, Illinois Real Estate Transfer Declaration Supplemental Form B. 11 12a 12b 13 14 15 16 17 18 19 20 21 Full actual consideration Amount of personal property included in the purchase Was the value of a mobile home included on Line 12a? Subtract Line 12a from Line 11. This is the net consideration for real property. Amount for other real property transferred to the seller (in a simultaneous exchange) as part of the full actual consideration on Line 11 Outstanding mortgage amount to which the transferred real property remains subject If this transfer is exempt, use an "X" to identify the provision. Subtract Lines 14 and 15 from Line 13. This is the net consideration subject to transfer tax. Divide Line 17 by 500. Round the result to the next highest whole number (e.g., 61.002 rounds to 62). Illinois tax stamps -- multiply Line 18 by 0.50. County tax stamps -- multiply Line 18 by 0.25. Add Lines 19 and 20. This is the total amount of transfer tax due. This form is authorized in accordance with 35 ILCS 200/31-1 et seq. Disclosure of this information is REQUIRED. This form has been approved by the Forms Management Center. IL-492-0227 11 12a 12b 13 14 15 16 17 18 19 20 21 $ ____________________ $ ____________________ ____ Yes ____ No $ ____________________ $ ____________________ $ ____________________ ____b ____k ____m $ ____________________ ____________________ $ ____________________ $ ____________________ $ ____________________ American LegalNet, Inc. www.FormsWorkFlow.com PTAX-203 (R-10/10) Page 1 of 4 Step 3: Write the legal description from the deed. Write, type (minimum 10-point font required), or attach the legal description from the deed. If you prefer, submit an 81/2" x 11" copy of the extended legal description with this form. You may also use the space below to write additional property index numbers, lots sizes or acreage from Step 1, Line 3. Step 4: Complete the requested information. The buyer and seller (or their agents) hereby verify that to the best of their knowledge and belief, the full actual consideration and facts stated in this declaration are true and correct. If this transaction involves any real estate located in Cook County, the buyer and seller (or their agents) hereby verify that to the best of their knowledge, the name of the buyer shown on the deed or assignment of beneficial interest in a land trust is either a natural person, an Illinois corporation or foreign corporation authorized to do business or acquire and hold title to real estate in Illinois, a partnership authorized to do business or acquire and