Form Rew-5 - Request For Exemption Or Reduction In Withholding Of Maine Income Tax On The Disposition Of Maine Real Property

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FORM REW-5
MAINE REVENUE SERVICES
INCOME/ESTATE TAX DIVISION - REW
P.O. Box 1064
Augusta, ME 04332-1064
Tel. 207-626-8473 Fax 207-624-5062
Email: realestate.withholding@maine.gov
REQUEST FOR EXEMPTION OR REDUCTION IN WITHHOLDING OF MAINE INCOME TAX ON
THE DISPOSITION OF MAINE REAL PROPERTY
This form must be submitted and granted prior to closing. No exemptions or reduced withholding
certifi cates will be granted after the closing date.
Applicant (seller) name: _______________________________________________________________________________________
Mailing address ______________________________________________________________________________________________
SSN or Fed. EIN: ___________________________________ Daytime phone no. _________________________________________
This is a request for a withholding rate reduction/exemption, per the Internal Revenue Code as operative under 36 M.R.S.A. § 5250-
A, or the provision of any United States treaty because the State of Maine tax liability on this sale will be less than the withholding.
The rate of withholding is 2.5% of total consideration or, at the request of the seller, the State Tax Assessor may prescribe a reduced
amount of withholding, equal to the gain multiplied by 8.5%.
1.
Attach a draft copy of the current Maine Real Estate Transfer Tax Declaration. If this form is not attached, Maine Revenue
Services will be unable to process your request. Contact your real estate escrow person (usually your real estate agent, title
company or attorney) for assistance in acquiring this form.
3.
Estimated date of closing on the property subject to the real
2.
Date property acquired _____________ . Method of
estate withholding requirement (i.e., the property
acquisition (purchase, gift, inheritance other/explain)
listed on related Form REW-1, line 9): ________________
__________________________________________
5.
List all uses of property during your ownership: (i.e., principal
4.
Total sales price of pending sale:
residence, rental, commercial, vacation home, etc.) _____
$ ___________________________
If rental/commercial use during your ownership, length of time:
years _____________ months ___________
6.*
Explain your gain/loss for this property for the year of sale, including an explanation of your adjusted basis computation per
IRS rules. ___________________________________________________________________________________________
___________________________________________________________________________________________________
7.*
Which IRS rule do you intend to follow to report the sale of property (i.e., exclusion of capital gain on principal residence,
like kind exchange, installment sale, etc.) __________________________________________________________________
___________________________________________________________________________________________________
7A.*
How do you qualify for this rule (list the highlights of this rule and how they relate to your sale). ______________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
8.
Attach copies of supporting documentation (i.e., proof of purchase price, notarized affi davit of intent to follow a nonrecogni-
tion of gain rule, etc.).
* Consult the Internal Revenue Service or your tax preparer for assistance in completing lines 6 through 7A. Complete lines 7 and 7A
only if you have a gain on line 6 and intend to follow a nonrecognition of gain rule or qualify to reduce this gain for the year of sale
per the Internal Revenue Code. Call this offi ce for assistance in completing this form.
Under penalties of perjury, I declare that I have examined this application and attached schedules and statements, and to the best of my
knowledge and belief they are true, correct and complete. You must have power of attorney to sign this form if you are not the applicant.
Do not forward the power of attorney to this offi ce.
Signed: ___________________________________________
Title: ___________________________________
Print name: ________________________________________
Date: ___________________________________
Rev. 09/12

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