Form Pt-172-S - Property Transfer Tax Return June 2015

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Buyer #1 or Entity _____________________________________________________
*151721500*
SSN or FID ___________________________________________________________
Property Location _____________________________________________________
Date of Closing _______________________________________________________
* 1 5 1 7 2 1 5 0 0 *
Attachment for
Form
Additional
VERMONT
SELLERS
PT-172-S
(Use Form PT-172-B to list
Property Transfer Tax Return
additional BUYERS)
SELLER #3
BLACK OUT ALL ID NUMBERS BELOW ON TOWN COPY ONLY
Entity SELLER #3 Name
Entity SELLER #3 Federal ID Number
Individual SELLER #3 Last Name
First Name
Initial
Individual SELLER #3 Social Security Number
SELLER #3 Mailing Address Following Transfer
For Department Use Only
City
State
ZIP Code
Foreign Country (if not United States)
SELLER #4
Entity SELLER #4 Name
Entity SELLER #4 Federal ID Number
Individual SELLER #4 Last Name
First Name
Initial
Individual SELLER #4 Social Security Number
SELLER #4 Mailing Address Following Transfer
For Department Use Only
City
State
ZIP Code
Foreign Country (if not United States)
SELLER #5
Entity SELLER #5 Name
Entity SELLER #5 Federal ID Number
Individual SELLER #5 Last Name
First Name
Initial
Individual SELLER #5 Social Security Number
SELLER #5 Mailing Address Following Transfer
For Department Use Only
City
State
ZIP Code
Foreign Country (if not United States)
SELLER #6
Individual SELLER #6 Last Name
First Name
Initial
Individual SELLER #6 Social Security Number
For Department Use Only
SELLER #6 Mailing Address Following Transfer
City
State
ZIP Code
Foreign Country (if not United States)
Form PT-172-S,
Additional SELLERS
For Town Use Only
(Attach to Form PT-172)
Rev. 06/15
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