Real Estate Transfer Declaration Form (Page 5 of 8) in pdf

Real Estate Transfer Declaration Form Page 5

CITY OF HARVEY

15320 BROADWAY AVENUE

HARVEY, IL 60426

AFFIDAVIT

I hereby certify that ____________________________________________________ is/are the

purchaser(s) of property located at ____________________________, Harvey, Illinois. I further

certify that I am aware of any code violations that have been cited by the City of Harvey against

said property as a result of a Point-of-Sale Inspection made on the _______ day of

_______________, 20___, which violations are hereby incorporated by reference.

Check ONE box below:

I hereby accept full responsibility for correcting said violations within a period not to

exceed one year of my obtaining an interest in said property. I further certify that I have

the power and authority to bind any and all other persons or parties who obtain an interest

in said property as a result of title, which is subject of this transaction.

I accept no responsibility for correcting said violations on the property. I hold the

seller fully responsible for correcting all violations and will not finalize the process to

transfer property until said violations are corrected by seller.

(NOTE:

TRANSFER

STAMPS WILL NOT BE ISSUED FOR THE SALE OF PROPERTY UNTIL VIOLATIONS ARE

CORRECTED BY SELLER.)

________________________________________ _______________________

Name of Purchaser

Date

________________________________________ _______________________

Name of Purchaser

Date

Subscribed to and sworn before me

A NOTARY PUBLIC this _______________ day of ____________________, 20_____.

___________________________________________________

NOTARY PUBLIC

City of Harvey Transfer Stamp Requirements-9/06

Real Estate Transfer Declaration Form Page 5