Fill and Sign the 521 Real Estate Transfer Statement Nebraska Department of Revenue Form

REAL PROPERTY TRANSFER DECLARATION 1. Address or legal description of real property. Enter the correct street address or legal description of the real property. Do not use mailing addresses or P.O. box numbers: ________________________________________________ ________________________________________________ 2. Is this transaction among related parties? Indicate whether the buyer or the seller were related. Related parties include persons within the same family, business affiliates, or affiliated corporations. Yes ___________ No____________ 3. Total sale price: Indicate the total consideration paid for the property including real estate, personal property (carpeting, drapes, appliances, inventory, equipment, furniture) mobile homes, sheds, goodwill, water rights, mine ral rights, and any other appurtenances. $______________________________________________ 4. What was the cash down payment: Enter the amount of the cash down payment, if any. If it is a cash sale, enter the total sales price. $_______________________________ _______________ 5. Did total sale price include a trade or exchange? Indicate whether any other real or personal property was traded or exchanged as part of the transaction. For example, mark "Yes" if a vacant lot was traded as the down payment or if the sal e included an amount for repair of the roof. Yes___________ No____________ 6. Did the buyer receive any personal property in the transaction? Indicate if any personal property as described in #3 was included in the total sales price. If yes, give the approxi mate value as of the date of the sale. Yes___________ No____________ If yes, the approximate value $______________________________________________ 7. Were mineral rights included in the sale? Indicate if any portion of the mineral rights were transferred to the grantee. Mineral right is defined as an interest in minerals in and under the land and all accompanying rights and privileges. Yes___________ No____________ 8. Were water rights included in the sale? Indicate if any water rights were transferred to the grantee. Water right is defined as the right to use the water of a natural stream or water furnished through a ditch or canal, for such purposes as irrigation, mining, power, or domestic use. Water rights are real property which may be sold and transferred separately from the land. Yes___________ No____________ 9. If applicable, you may include goodwill for a going business. If the sale price included an amount for goodwill of an on -going business, indicate the approximate consideration paid. Goodwill is defi ned as the benefit or advantage of having an established business occupying the property. Goodwill represents the difference between the purchase price and the value of the net assets. Approximate value of goodwill $________________________________________ ________ 10. Was less than 100% interest in the real property conveyed? Mark "Yes" if only a partial interest is being conveyed. Mark "No" if the grantee is to have the benefit of 100% interest in the property. Yes___________ No____________ 11. Date of Closing: Enter the date upon which the transfer of the property was completed. ________________________________________________. IF THE PROPERTY IS FINANCED, PLEASE COMPLETE #12 -#15 12. Was the loan new________________ or assumed___________________? Indicate if the grantee obtained a new loan or assumed an existing loan on the property. 13. What was the interest rate on the loan? Enter the mortgage interest rate to be applied to the loan as stated in the financing agreement. _______________________________% 14. What was the term of the loan? Enter the length of time that will expire before the loan is fully paid as stated in the financing agreement. (10 years, 20 years, etc.) _______________________________years 15. Were any points paid? For the purpose of this document, a poin t is defined as a fee or charge equal to one percent of the principal amount of the loan which is collected by the lender at the time the loan is made. If any points were paid in securing this loan, indicate how many were paid and if the points were paid b y the buyer, seller, or both. Yes___________ No____________ If yes, how many by buyer? ___________. How many by seller? ___________. 16. Enter the day, month, and year, and have at least one of the parties sign the document, marking the pertinent identificat ion of each. Signed this ____________________ day of______________________, ___________. ( ) Grantor ( ) Grantee