AFFIDAVIT FOR REALTY TRANSFER TAX ON UNINCORPORATED
AREAS IN SUSSEX COUNTY PURSUANT TO CHAPTER 103 OF
THE SUSSEX COUNTY CODE
NOTE: Affidavit is required on all transactions (incorporated or unincorporated areas)
Part A — To Be Completed By GRANTOR/SELLER
SOCIAL SECURITY #
or
EMPLOYER I.D. #
NAME
ADDRESS
CITY
STATE ZIP
Part B — To Be Completed By GRANTEE/BUYER
SOCIAL SECURITY #
or
EMPLOYER I.D. #
ZIP
NAME
ADDRESS
CITY
STATE
Part C — PROPERTY LOCATION
Map Parcel District
Part D — COMPUTATION OF THE TAX
1. CONVEYANCES WITH CONSIDERATION
Enter Consideration Received
2. CONVEYANCES WITHOUT CONSIDERATION
Enter Highest Assessed Value For Local Tax Purposes
$
3. Enter the Greater, Line 1 or Line 2
$
4. Multiply Line 3 times 1.50% — Tax Due and Payable
$
EXEMPT CONVEYANCES: If transaction is exempt from Transfer tax, explain the basis for the exemption:
First Time Home Buyer? Yes No (If "Yes", attach First Time Home Buyer Affidavit)
Sworn and Subscribed before me on
this _
__
__
__
__
day of
_____________________
,
20
____
Seller's Signature
_______________________________________________
Notary Public
OFFICE USE ONLY:
Revised 04/16/2020
$
