New Property Owner Form

NEW PROPERTY OWNER FORM

This form is to be completed by the person or entity that holds legal title to the property described below. Completion and signature certify that the information provided is true, complete and accurate, and that required supporting documents will be provided upon request.

Property Identification

Recording Instrument Number:     Recorded Date:

Owner Information

Entity / Vesting Type (check applicable):
Individual   Joint Tenants   Tenants in Common   Corporation   Limited Liability Company (LLC)   Trust   Other

Mailing and Contact Information

Preferred recipient of tax bills and official notices:
Owner   Agent / Representative

Ownership and Transaction Details

Effective Date of Ownership Transfer:     Purchase Price (if applicable):

Are there existing mortgages or recorded liens on the property?
Yes   No

Property Disclosures

Lead-based paint disclosure:
Yes   No

Known structural damage or prior major repairs:
Yes   No

Located in a flood zone or subject to special flood insurance requirements:
Yes   No

Presence of hazardous materials or environmental concerns (as known to owner):
Yes   No

Acknowledgments and Authorizations

By signing below, the undersigned Owner certifies under penalty of perjury that the information contained in this form is true, correct and complete to the best of the Owner's knowledge. Owner acknowledges responsibility for property taxes and assessments from the effective date of ownership transfer until change of record is properly filed and accepted.

Owner authorizes the release of tax billing information to the named Agent/Representative (if designated above) for the purpose of receiving bills, statements and notices relating to the referenced property. Owner agrees to promptly notify the recording authority of any subsequent change in mailing address, vesting or ownership.

Owner further understands that submission of false information may subject the signer to administrative penalties and potential civil or criminal liability under applicable law. This form, together with attachments, constitutes the Owner's written notice of change in ownership and is governed by the laws applicable to the jurisdiction in which the property is located.

Required Attachments (Check and attach)

Recorded deed or instrument transferring title
Trust instrument or certification (if trust is owner)
Articles of incorporation / organization (if entity owner)
Power of attorney (if signing on behalf of owner)
Other supporting documentation

Optional Additional Information

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