Real Property Certificate Of Value Template - St Louis County

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REAL PROPERTY CERTIFICATE OF VALUE
ST LOUIS COUNTY
Type or print all information. All questions must be answered by grantee.
DATE ____/____/____
1.
Grantor:
DAILY ____________
2.
Grantee:
3.
Address of Property:
Locator(s):
4.
Is this newly constructed residential property? Yes
, No
. If "Yes", date of occupancy:
Intended use of property? Present use
, Renovation
5.
, New Development
, Short term Investment
6.
Did the transaction transfer title in any of the following ways:
A.
To or from any governmental or political agency?.............................................................................
- Yes
B.
For the purpose of correcting a previously recorded deed?..............................................................
- Yes
C.
For the purpose of releasing security for a debt?..............................................................................
- Yes
D.
Sale for delinquent taxes?.................................................................................................................
- Yes
E.
Sale of cemetery lot?.........................................................................................................................
- Yes
F.
Transfer of severed mineral interests?...............................................................................................
- Yes
G.
By order of any court?.......................................................................................................................
- Yes
H.
By deed between husband & wife, parent & child, without actual consideration; to or from
a family corporation or partnership or trust for no consideration?......................................................
- Yes
I.
By deed of partition?..........................................................................................................................
- Yes
J.
By deed made pursuant to merger, consolidation, sale or transfer of the assets of a
corporation pursuant to a plan filed with the Missouri Secretary of State?.......................................
- Yes
- Yes
K.
By executory contract for deed?........................................................................................................
L.
By deed of distribution conveying property to heirs? ........................................................................
- Yes
M.
By lease or easement?......................................................................................................................
- Yes
N.
By deed which conveys property held in name of partnership to any partner or partner's
spouse?.............................................................................................................................................
- Yes
If any of the above are marked yes, go to item 10.
7.
Did this transaction involve any of the following:
A.
A transaction between relatives or related corporations?...................................................................
- Yes
B.
A compulsory transaction in lieu of foreclosure, divorce, court order, condemnation, probate?
- Yes
C.
A transaction with one of the following types of deed: Quit Claim Deed, Trustee's Deed,
Deed conveying less than full fee simple interest in property?..........................................................
- Yes
If a, b, or c was answered yes, explain:
8.
A. Full consideration, including the amount of all assumed mortgages and liens, excluding personal property:
Mortgage(s): $
Cash: $
Total: $
B.
If a gift, in whole or part, state the estimated market value of the gift portion: $
Yes
, No
C.
Was a trade of property involved in this transaction?
If “Yes” estimate the value and describe the traded property: Estimated Value: $
Describe Property:
9.
If you believe this transaction does not represent market value, please attach any additional information that you
want the County Assessor to consider.
10.
I certify under the penalty of law that this statement has been examined by me and to the best of my knowledge
and belief is a true, correct and complete statement.
DATE
SIGNATURE OF GRANTEE OR HIS REPRESENTATIVE
PRINT NAME AND POSITION
THIS CERTIFICATE TO BE FILED WITH DEED AT TIME OF RECORDING
FORM COV1 REV: 12/09
Print Form

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