R90-102 AUTHORIZING CONVEYANCE OF PROPERTY AND ACCEPTANCE OF PROPERTY

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�� Illinois Department of Revenue or se y oun y eco ers ice ' County Property Tax Administration Bureau REAL ESTATE TRANSFER DECLARATION �ate THE FOLLOWING INFORMATION IS REQUIRED HY THE REAL ESTATE TRANSFER TAX ACf(CHAP. Doc. No. 120,PAR.1003,IL REV.STAT.).PAGES 1 THROUGH�ARE TO BE FILLED OUT BY THE SELLERS" AND BUYERS' OR THEIR AGENTS.ANY WILLFUL FALSIFICATION OR WILLFUL OMISSION Of INFORMATION IS A CLASS B MISDEMEANOR(CHAP.120,PAR.1005,IL REV.STAT.). V01. EXCEPT AS TO EXEMRT TRANSACTIONS,THE COUNTY RECORDER OF DEEDS IS PROHIBITED BY LAW FROM A�CEFTING A�Y DEED OR TRANSFER OF BENEFICIAL INTEREST OF A LAND �ge TRUST (TRUST DOCUMENT) FOR RECORDATION UNLESS IT IS ACCOMPANIED BY THIS , DECLARATION CONTAINING ALL OF THE INFORMATION REQUESTED HEREIN(CHAP.120,PAR. 1003, IL REV. STAT.). Rec'd. By: PROPERTY IDENTIFICATION Address of Property N/A Decatur Decatur Street City or Village Township Permanent Real Estate Index No. N�p' Date of Deed �� 9� (or Trust Daument) (Month/Year) Enter Legal Description on Page 2 of this form. Type of Deed 4uit Claim (or Trust Document) PROPERTY CHARACTERISTICS SALE INFORMATION (fhe following questions must be answered) LOt Size NOTE: If the answer to any of the to�lowin g questions is"Yes",you do not have to complete the Finance Schedule at the top of pages 2 and 3 of this declaration or the Finance Questions at the bottom of this page. Acreage Check type of improvement on property Yes No f�VaCant land/lot 1. Is this a transfer between relatives or related corporations? ❑ � ❑ Residence(Single family or duplex) 2. Is this a compulsory transaction in lieu oi foreclosure, O Mobile home divorce,court order,condemnation,probate,etc.? ❑ � ❑Apartment bldg. (6 units or less) 3. Was this a transfer in settlement of an installment contract ❑COmmerCial apartment(Over 6 units) tor deed initiated prior to the CURRENT year? O � ❑ Store, office, commercial bldg. Enter contract year ❑ Industrial bldg. 4. Was the deed any of the following types: � ❑ ❑ Farm, land only •Sheriff's Deed •Judge's Deed •Quit Claim Oeed •Conveyance of Less than �/. Interest O Farm, with bldgs. •Trust Document which Refers to COLLATERAL ASSIGNMENT of Beneficial Interest of Trust O Other S ecif TERMS OF SALE Full Actual Consideration (Sale Price) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 562.50 Less amount of personal property included in purchase (Do not deduct value of beneficial interest of a land trust) $ Net consideration for real property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 562.50 Less value of other real property transferred to seller as part of full consideration . . . . . . . . . . $ Less amount of mortgage to which the transferred real property remains subject . . . . . . . . . . . $ Net taxable consideration subject to transfer tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 562.50 CALCULATION OF TRANSFER TAX Amount of State of Illinois tax stamps ($.25 per $500 or part thereof of taxable consideration) . $. NJA Amount of county tax stamps ($ per �500 or part thereof of taxable consideration) . . . . . $_ N/A Total Transfer Tax Collected $ N/A se this space to escri any specia arcumstances u�vo ving t is transact�on: Exempt under provisions of Paragraph b, Section 4, Real Estate Transfer Tax Act. FINANCE QUESTIONS: The buyer• and setler�(or their representatives)must answer all the tollowing questions un/ess one o�more oi the Sale Information questions above was checked"Yes". If the Sale Information questions are all marked"No"and any of the following questions are answered"Yes",the buyer•or buyer's' representative MUST wmplete the FINANCE SCHEDULE on pages 2 and 3.If the answer to all of the questions below is"No",omit completion of the FINANCE SCHEDULE and go directly to the LEGAL DESCRIPTION on page 2 and signature spaces on page 3. Yes No 1. Did the buyer assume the seller's mortgage? OR If this transaction is a transfer of If FINANCE QUESTIONS a beneficial interest of a land trust,does property REMAIN SUB.IECT to a mortgage? p ❑ 1 through 5 2. Did the seller' prrnide a mortgage in partial or full consideration? ❑ p are answered ��NO�; 3. Did the seller• pay points to secure the buyer's' mortgage, including VA and FHA insured loans? ❑ ❑ DO NOT complete 4. Did the seller's" mortgagee make interest concessions to the buyer•, i.e.,offer a "blended" Finance Schedule interest rete below market but greater than the seller's existing mortgage rete? ❑ p on Pages 2 and 3. 5. Was the financing in any other manner unique or specifically associated with the property being trensferred,e.g.,builder"buy down"oT interest,etc.? ❑ ❑ PfAB-203(R-12l85) IL-492-0027 ' If this t2nsaction is a transier oi a benetinal interest ot a land trust read Assignor for Setler anA Assignee for Buyer pape 1