Fillable Form Git/rep-3 - Seller'S Residency Certification/exemption printable pdf download

GIT/REP-3

State of New Jersey

(9-2015)

SELLER’S RESIDENCY CERTIFICATION/EXEMPTION

(Please Print or Type)

SELLER’S INFORMATION

Name(s)

Current Street Address

City, Town, Post Office Box

State

Zip Code

PROPERTY INFORMATION

Block(s)

Lot(s)

Qualifier

Street Address

City, Town, Post Office Box

Zip Code

State

Seller’s Percentage of Ownership

Total Consideration

Owner’s Share of Consideration

Closing Date

SELLER’S ASSURANCES (Check the Appropriate Box) (Boxes 2 through 14 apply to Residents and Nonresidents)

1. ¨ Seller is a resident taxpayer (individual, estate, or trust) of the State of New Jersey pursuant to the New Jersey Gross Income Tax Act,

will file a resident gross income tax return, and will pay any applicable taxes on any gain or income from the disposition of this

property.

2. ¨ The real property sold or transferred is used exclusively as a principal residence as defined in 26 U.S. Code section 121.

3. ¨ Seller is a mortgagor conveying the mortgaged property to a mortgagee in foreclosure or in a transfer in lieu of foreclosure with no

additional consideration.

4. ¨ Seller, transferor, or transferee is an agency or authority of the United States of America, an agency or authority of the State of New

Jersey, the Federal National Mortgage Association, the Federal Home Loan Mortgage Corporation, the Government National Mortgage

Association, or a private mortgage insurance company.

¨ Seller is not an individual, estate, or trust and is not required to make an estimated gross income tax payment.

¨ The total consideration for the property is $1,000 or less so the seller is not required to make an estimated income tax payment.

7. ¨ The gain from the sale is not recognized for federal income tax purposes under 26 U.S. Code section 721, 1031, or 1033 (CIRCLE

THE APPLICABLE SECTION). If the indicated section does not ultimately apply to this transaction, the seller acknowledges the

obligation to file a New Jersey income tax return for the year of the sale and report the recognized gain.

¨ Seller did not receive non-like kind property.

8. ¨ The real property is being transferred by an executor or administrator of a decedent to a devisee or heir to effect distribution of the

decedent’s estate in accordance with the provisions of the decedent’s will or the intestate laws of this State.

9. ¨ The real property being sold is subject to a short sale instituted by the mortgagee, whereby the seller agreed not to receive any

proceeds from the sale and the mortgagee will receive all proceeds paying off an agreed amount of the mortgage.

10. ¨ The deed is dated prior to August 1, 2004, and was not previously recorded.

11. ¨ The real property is being transferred under a relocation company transaction where a trustee of the relocation company buys the

property from the seller and then sells the house to a third party buyer for the same price.

12. ¨ The real property is being transferred between spouses or incident to a divorce decree or property settlement agreement under 26

U.S. Code section 1041.

13. ¨ The property transferred is a cemetery plot.

14. ¨ The seller is not receiving net proceeds from the sale. Net proceeds from the sale means the net amount due to the seller on the

settlement sheet.

SELLER’S DECLARATION

The undersigned understands that this declaration and its contents may be disclosed or provided to the New Jersey Division of Taxation and that any false

statement contained herein may be punished by fine, imprisonment, or both. I furthermore declare that I have examined this declaration and, to the best of

my knowledge and belief, it is true, correct and complete. By checking this box o I certify that a Power of Attorney to represent the seller(s) has been

previously recorded or is being recorded simultaneously with the deed to which this form is attached.

__________________________________________

_____________________________________________________________________

Date

Signature

(Seller) Please indicate if Power of Attorney or Attorney in Fact

__________________________________________

_____________________________________________________________________

Date

Signature

(Seller) Please indicate if Power of Attorney or Attorney in Fact