Ptax-203-Nr Form - Illinois Real Estate Transfer Tax Payment Document (Non Recorded Transfers)
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2Do not write in this area.
PTAX-203-NR
This space is reserved for the County Recorder’s Office use.
County:
Illinois Real Estate Transfer Tax Payment
Document
(non recorded transfers)
Date:
This document is recorded for the purpose of affixing Real Estate
Doc. No.:
Transfer Tax stamps that were purchased for the following transferring
document under provisions of Public Act 93-1099.
Vol.:
Property information
____________________________________________________
Page:
Street address of property (or 911 address, if available)
____________________________________________________
Received by:
City or village
ZIP
Township
Parcel identifying number __________________________________________________________________________________________
__________________________________________________________________________________________________________________
Legal description___________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
Date of transferring document:
____ ____ / ____ ____ ____ ____
Month
Year
Type of transferring document: _____________________________________________________________________________________
Signature
________________________________________________________________________________________________________________
Seller, Buyer, Agent, or Preparer
Date
Preparer Information
(Please print.)
________________________________________________________________________________________________________________
Preparer’s and company’s name
Preparer’s file number (if applicable)
________________________________________________________________________________________________________________
Street address
City
State
ZIP
_________________________________________________________________________ ______________________________________
Preparer’s signature
Preparer’s daytime phone
_______________________________________________
Preparer’s e-mail address (if available)
Transfer Tax
Net consideration subject to transfer tax
$ ______________________
Illinois Tax
$ ______________________
County Tax
$ ______________________
Total amount of transfer tax due
$ ______________________
Affix Revenue stamps here
If stamps are not affixed, please state the exemption provision under 35 ILCS 200/31-45 (see Page 2). _______________________________
This form is authorized in accordance with 35 ILCS 200/31-1 et seq. Disclosure of this information
is REQUIRED. This form has been approved by the Forms Management Center.
IL-492-4443
PTAX-203-NR (R-6/05)
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