Form Rp-5217-Cf - Real Property Transfer Report Sale Information Correction Form Page 2

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RP-5217-CF (7/94)
2
1. State the Full Sales Price. (Full sales price is the total amount paid for the property, including personal
property. This payment may be in the form of cash, other property or goods, or the assumption of mortgages
or other obligations).
$___________________
2. Indicate the value of the personal property included in the sale.
$___________________
3. Indicate the sale contract date. If land contract sale, specify date
of initial contract.
____________________
4. Indicate the date of sale/transfer.
____________________
PART II: ERROR IN CONDITION OF TRANSFER
5. Check one or more of these conditions as applicable to transfer:
_______ Sale Between Relatives
_______ Sale Between Related Companies or Partner in Business
_______ One of the Buyers is also a Seller
_______ Buyer or Seller is a Government Agency or a Lending Institution
_______ Deed Type is not Warranty or Bargain and Sale (specify deed type)
_______________________________________________________________
_______ Sale of Fractional or Less than Fee Interest (specify) _____________________
_______ Sale of Business is Included in Sale Price
_______ Other Unusual Factors Affecting Sale Price (specify) _____________________
_______ None of the above conditions apply.
CERTIFICATION
Your participation in the transfer was:
_____Buyer
_____Seller
_____Agent
______Other (specify) _____________________
Were you the person who signed the original Real Property Transfer Report Form (RP-5217)?
______Yes
______No
I certify that all the items of information entered on this page are true and correct (to the best of my knowledge and
belief) and I understand that the making of any willful false statement of material fact herein will subject me to the
provisions of the Penal Law relative to the making and filing of false instruments.
Name (Print or Type): _____________________________________ Telephone # (_____) ____________________
Signature _______________________________________________ Date _________________________________
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