Real Estate Transfer Declaration Form Page 8
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8CITY OF HARVEY
15320 BROADWAY AVENUE
HARVEY, IL 60426
CODE HEARING DIVISION CLEARANCE FORM
FOR TRANSFER STAMP PURCHASE
DATE: _________________________
OWNER/SELLER NAME:
__________________________________________________________
ADDRESS:
__________________________________________________________
BUYER’S NAME:
__________________________________________________________
ADDRESS:
__________________________________________________________
TELEPHONE NUMBER:
__________________________________________________________
PROPERTY ADDRESS:
__________________________________________________________
P.I.N. #:
__________________________________________________________
For office use only
HOUSING FINES/LIENS ON PROPERTY:
YES / NO
(please circle)
Ticket No./Lien No.
Ticket/Lien Date
Amount
Amount Paid: ________________________________
Date Paid:__________________
Staff Initials: _______________
8
City of Harvey Transfer Stamp Requirements-9/06
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