Form Mw506ae - Application For Certificate Of Full Or Partial Exemption - 2013 Page 2
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Application for Certificate of Full or Partial Exemption
Page 2
MW506AE
2013
Transferor/Seller’s Name
Your Social Security number/FEIN
Reason for Full or Partial Exemption from Withholding (Attach documentation and calculation)
1.
Transfer is of a principal residence as defined in IRC §121.
2.
Transfer is a tax-free exchange for purposes of IRC §1031 and is treated as:
simultaneous without boot,
simultaneous with boot, or
delayed, with funds in escrow for acquiring replacement property.
3.
Transfer is pursuant to an installment sale under IRC § 453 and the transferor/seller will receive less than the full
purchase price during the taxable year.
4.
Transfer of inherited property is occurring within 6 months of date of death.
5.
Transferor/Seller is receiving zero proceeds from this transaction. (See instructions)
6.
Transfer is pursuant to a transaction under a specific section of the Internal Revenue Code or other code. Place code
letter for your transaction in the box below. (See instructions for detailed descriptions):
7.
Other (examples: selling for a loss, actual gain, etc.). Provide a brief explanation in the space provided:
Address to Mail Certificate if Issued
Please provide the name and address of the person to whom we should mail the exemption certificate if issued.
Name of contact person and company
Street Address
City
State
Zip code
Calculation of Tax to be Withheld
1. Enter the amount subject to tax witholding. Subtract adjusted basis from contract sales price. . . . . . .
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2. Enter tax rate, whichever applies.
a. If you are a business entity, enter 8.25%
. . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
2
. . . . . . . . . . . . . . .
b. If you are an individual, enter 7%
. . . . . . . . . . . . . . . . . . .
3. Amount of tax to be withheld at closing. Line 1 multiplied by line 2. (This line MUST be completed.) . .
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Under the penalties of perjury, I declare that I have examined this application, including any schedules or state-
ments attached, and to the best of my knowledge and belief, it is true, correct and complete. If prepared by a per-
son other than taxpayer, the declaration is based on all information of which the preparer has any knowledge.
Please
___________________________________
_____________________
_____________________
Sign
Signature
Applicant’s phone number
Date
Here
_____________________________________________________
________________________________
________________________________
Signature
Applicant’s phone number
Date
COM/RAD-306
12-49
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