R97-57 AUTHORIZING FINAL CONVEYANCE OF HOMESTEAD PROPERTY

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� Illinois Department of Revenue For Use By County Recorders on� ' ' ,, County Local Government Services Bureau REAL ESTATE TRANSFER DECLARATION �ate THE FOLLOWING INFORMATION IS REQUIRED BY THE REAL ESTATE TRANSFER TAX LAW(35 DOC. No. ILCS 200/31•25). PAGES 1 THROUGH 3 ARE TO BE FILLED OUT BY THE SELLERS' AND BUYERS'OR THEIR AGENTS.ANY WILLFUL FALSIFICATION OR WILLFUL OMISSION OF IN- I FORMATION IS A CLASS B MISDEMEANOR(35 ILCS 200/31-50). V01. I EXCEPi AS TO EXEMPT TRANSACfIONS,THE COUNTY RECORDER IS PROHIBITED BY LAW li FROM ACCEPfING ANY DEED OR TRANSfER OF BENEFICIAL INTEREST OF A LAND TRUST Page (TRUST DOCUMENn FOR RECORDATION UNLESS IT IS ACCOMPANIED BY THIS DECLARA- ' TION CONTAINING ALL OF THE INFORMATION REQUESTED HEREIN(35 ILCS 200/31-25). I Rec'd. By: PROPERTY IDENTIFICATION II 2180 N. Graceland Ave Decatur Decatur Cit �' Address �f �ro�erty , Street City or Viliage Township Permanent Real Estate Index No. 04-12-03-378-014 Date of Deed /1997 I Enter Legal Description on Page 2 of this form. (aT�� (Month/Year) ' Type of DeedWarranty Deed � NOTICE: The State of Illinois has enacted a Smoke Detector Act. (arr�scoau� Statutory PROPERTY CHARACTERISTICS SALE INFORMATION (The following questions must be answered.) I..ot Size Approx. 41' x 90' NCJTE:You do not have to complete the Finance Questions at the bottom of this page or the Finance Schedule at the top of pages 2 and 3 of this form, if you answer any of the following questions"Yes". Acreage Yes No CheCk type Of improvement on property 1. Is this a transfer between relatives or related parties? ❑ [� ❑VaCent land/IOt 2. Is this a compulsory transaction in lieu of foreclosure, �Residence(Single family or duplex) divorce,court order,condemnation,probate,etc.? ❑ � ❑ Mobile home(see note on page 2) 3. Was this a transfer in settlement of an installment contrad ' ❑Apartment bldg. (6 units or less) for deed initiated prior to the year of raording? o Oc ❑Commercial apartment(Over 6 units) If"Yes",enter contract year ❑Store, offite, COmm2YCial bldg. SPEC/AL NOTE:N contract y�ar is the same as yaar of recording,answer this question "No" � Industl'ial bldg. 4. Was the deed any of the following types: ❑ CX , ❑ Farm, land Only •Sheriff's Deed •Judge's Deed •Quit Claim Deed •Conveyance of Less than full Interest ❑ Farm, with bldgs. •Trust Document which Refers to COLLATERAL ASSIGNMENT of Beneficial Interest of Trust ❑Other(Speci TERM� OF SALE II Full Actual Consideration (Sale Price) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2 7 ,0 0 0 .0 0 Less amount of personal property included in purchase(Da not deduct value of beneficial interest of a land trust.) $ —�— Net consideration for real property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2 7 .0 0 0 . 0 0 I Less value of other real property transferred to seller as part of full consideration . . . . . . . . . . $ _�_ Less outstandin amount of mort a e ta which the transferred real ro ert remains sub�ect . . � g g g p P Y 1 $ I, Net taxable consideration subject to transfer tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Exempt * CALCULATION OF TRANSFER TAX Amount of State of Illinois tax stamps ($.50 per $500 or part thereof of taxable consideration) . $ Exempt Amount of county tax stamps ($.25 per $500 or part thereof of taxable consideration) . . . . . . . $ Exempt Total Transfer Tax Collected $ Exempt se this spac�escri a�e ny speciaTcircumstances in�ing tris transaction: * This transfer is exem t under Para ra h b of the Real Estate vo v P g P Transfer Act, Chapter 35 ILCS 305/4 . FINANCE QUESTIONS: If the answer is"No"to all of the above Sale Information questions,ALL of the following questions must be answe►ed.If any of the questions below are answered"Yes"the buyer'or buyer's' representative MUST complete the Finance Schedule on the top of pages 2 and 3. Yes No If FINkNCE QUESTIONS 1. Does property REMAIN SUB.IECT to a mortgage such as an assumed mortgage? ❑ � 1 �f1f0Ugf1 5 2. Did the seller* provide a mortgage in partial or full consideration? ❑ � are answered `�NO��, 3. Did the seller• pay points to secure the buyer's' mortgage, including VA and FHA insured loans? 0 � DO NOT complete 4. Did the seller's' mortgagee make interest concessions to the buyer•,i.e.,offer a "blended" Finance Schedule interest rate below market but greater than the seller's existing mortgage rote? ❑ � on Pages 2 and 3. 5. Was the financing in any other manner unique or spec'rfically associated with the property -being transferred,e.g., builder"buy down"of interest,etc.? ❑ � " If this transaction is a transier of a beneficial interest of a Iand trust,substitute the word Assignor fa Selkr and Aasi�nee fa Buyer. PTAX-203(R-4/94) . Page 1 of 4