Form Rew-3 - Residency Affidavit Of Entity Transferor

FORM REW-3

MAINE REVENUE SERVICES

Income/Estate Tax Division - REW

P.O. Box 1064

Augusta, ME 04332-1064

Tel. 207-626-8473

Fax 207-624-5062

RESIDENCY AFFIDAVIT OF ENTITY TRANSFEROR

36 MRSA § 5250-A provides that a buyer (transferee) of real property located in Maine must withhold tax if the

seller (transferor) is not, as of the date of transfer, a resident of the State of Maine. To inform the buyer that withholding

of tax is not required upon the disposition of State of Maine property interest, the undersigned hereby certiﬁ es the follow-

ing on behalf of _______________________________________ :

(name of transferor)

Check only the box(es) that apply:

The above named entity is a resident corporation that is incorporated in the State of Maine or maintains a perma-

nent place of business in Maine as of the date of transfer.

The above named entity is a resident estate or trust which has not established domicile outside of Maine as of the

date of transfer.

The above named entity is a resident partnership of which at least 75% of ownership interest is held by residents

of the State of Maine. Limited Liability Companies (“LLCs”) are considered partnerships unless otherwise clas-

siﬁ ed for federal income tax purposes, in which case the LLC is classiﬁ ed in the same manner for real estate with-

holding as it is classiﬁ ed for federal income tax purposes.

Complete the following lines:

1. Seller’s employer identiﬁ cation number: ___________________________________________

2. Seller’s Maine ofﬁ ce address:

__________________________________________________________________________

3. Seller’s mailing address:

__________________________________________________________________________

The above named entity understands that this certiﬁ cation may be disclosed to the State Tax Assessor, by the buyer and

that any false statement contained herein is punishable by ﬁ ne, imprisonment or both.

Authorized signature

Title

Date

Contact person phone number

State of _________________________ , County of _______________________ , SS

Personally appeared before me the above named _____________________________ , and acknowledged the above

(Seller)

instrument to be his free act and deed in his said capacity. __________________________________________________

Notary Public

Date

NOTE: The buyer, or real estate escrow person, must retain a signed original afﬁ davit.

Closing Agents/Title Companies must attach a copy of the completed/signed/notarized Form REW-3 to the Maine

Real Estate Transfer Tax Declaration indicating residency status on all transfers. These forms are then submitted to

Maine Revenue Services’ Property Tax Division for further processing by the Registry of Deeds.

Rev. 11/10

Form Rew-3 - Residency Affidavit Of Entity Transferor - 2010

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