Return For Transfers Of Interest In Real Property Form - Florida Department Of Revenue
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2FDOR10240300
FLORIDA DEPARTMENT OF REVENUE
DR-219
RETURN FOR TRANSFERS OF INTEREST IN REAL PROPERTY
R. 07/98
(PLEASE READ INSTRUCTIONS BEFORE COMPLETING)
Use black ink. Enter numbers as shown below.
If typing, enter numbers as shown below.
0 0 0 0 0 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 4 4 4 4 4 5 5 5 5 5 6 6 6 6 6 7 7 7 7 7 8 8 8 8 8 9 9 9 9 9
0123456789
1. Parcel Identification Number
(If Parcel ID not available
please call County Property
Appraiser’s Office)
Property was improved
Transaction is a split
2. Mark (x) all
Multi-parcel
with building(s) at time
or cutout from
that apply
transaction?
of sale/transfer?
another parcel?
3. Grantor (Seller):
Last
First
MI
Corporate Name (if applicable)
(
)
Mailing Address
City
State
Zip Code
Phone No.
4. Grantee (Buyer):
Last
First
MI
Corporate Name (if applicable)
(
)
Mailing Address
City
State
Zip Code
Phone No.
Sale/Transfer Price
5. Date of Sale/Transfer
$
,
,
Property
County Code
0 0
/ / / / /
/ / / / /
County
Located In
(County Codes on Reverse)
(Round to the nearest dollar.)
Month
Day
Year
/ / / / /
Contract/Agreement
Other
7. Are any mortgages on the property? If “Yes”,
YES
NO
6. Type of Document
for Deed
outstanding mortgage balance:
Warranty
,
$
,
0 0
Quit Claim
(Round to the nearest dollar.)
Deed
Deed
8. To the best of your knowledge, were there unusual circumstances or conditions to the sale/transfer
such as: Forced sale by court order? Foreclosure pending? Distress Sale? Title defects? Corrective Deed? Mineral rights?
/ / / / /
YES
NO
Sale of a partial or undivided interest? Related to seller by blood or marriage.
/ / / / /
9. Was the sale/transfer financed?
YES
NO
If “Yes”, please indicate type or types of financing:
Agreement or
Conventional
Seller Provided
Contract for Deed
Other
Institutional/
10. Property Type:
Commercial
Agricultural
Miscellaneous
Government
Vacant
Acreage
Timeshare
Residential
Industrial
Mark (x) all
that apply
Cents
/ / / / /
$
,
,
11. To the best of your knowledge, was personal property
YES
NO
0 0
included in the sale/transfer? If “Yes”, please state the
$
amount attributable to the personal property. (Round to the nearest dollar.)
,
,
12. Amount of Documentary Stamp Tax
/ / / / /
13. If no tax is due in number 12, is deed exempt from Documentary Stamp Tax under s. 201.02(6), Florida Statutes?
YES
NO
Under penalties of perjury, I declare that I have read the foregoing return and that the facts stated in it are true. If prepared by someone other
than the taxpayer, his/her declaration is based on all information of which he/her has any knowledge.
Signature of Grantor or Grantee or Agent
Date
WARNING: FAILURE TO FILE THIS RETURN OR ALTERNATIVE FORM APPROVED BY THE DEPARTMENT OF REVENUE SHALL RESULT IN A PENALTY OF $25.00 IN ADDITION TO ANY
OTHER PENALTY IMPOSED BY THE REVENUE LAW OF FLORIDA.
To be completed by the Clerk of the Circuit Court’s Office
Clerks Date Stamp
This copy to Property Appraiser
O. R. Book
and
Reset Form
Page Number
and
File Number
/ / / / /
/ / / / /
Date Recorded
Month
Day
Year
This copy to Property Appraiser
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