FOR OFFICE USE ONLY
Rev. Code 0050
5.
The Grantor is a:
Resident Individual
Non-Resident Individual
Domestic Corporation (Delaware)
Foreign Corporation (Non-Delaware)
S Corporation
Government Agency
Fiduciary (Estate or Trust)
Partnership
Non-ProtCorporation
PART A - TO BE COMPLETED BY GRANTOR/SELLER
EnterEmployerIdenticationNumber
orSocialSecurityNumberoftheGrantor
NameofGrantor
Address
City State Zip Code
County
Dateofrealestateconveyance
1.
2.
3.
4.
County
New Castle
Kent
Sussex
2. Entertheamountofconsiderationreceivedincludingcash,checks,mortgages,liens,encumbrances,
andanyothergoodandvaluableconsideration..................................................................................................................
Waslikekindpropertyexchanged? Yes No(Ifyes,seeinstructions.)
3.Enterthehighestassessedvalue(forlocaltaxpurposes)oftherealestatebeingconveyed...........................................
Waslikekindpropertyexchanged? Yes No(Ifyes,seeinstructions.)
4.EnterthegreaterofLine2orLine3....................................................................................................................................
5.PercentagerateofRealtyTransferTaxpaidtotheStateofDelaware,countyand/ormunicipality....................................
4.0%
6.PercentagerateofRealtyTransferTaxpaidtothecountyormunicipality..........................................................................
7.Reductionforcontractsexecutedpriorto8/1/2017(seeinstructions).................................................................................
8.DelawareRealtyTransferTaxpercentage(subtractlines6and7fromline5)....................................................................
9.DelawareRealtyTransferTaxBeforeCredits(multiplyline4byline8)................................................................................
10.Credit-FirstTimeHomebuyer(SeeInstructionsandmustattachForm5402Schedule1)..............................................
11.DelawareRealtyTransferTaxDue(Subtractline10fromline9).......................................................................................
PART C - PROPERTY LOCATION AND COMPUTATION OF THE TAX
Address
City State Zip Code
1.
4.
The Grantee is a:
Resident Individual
Non-Resident Individual
Domestic Corporation (Delaware)
Foreign Corporation (Non-Delaware)
S Corporation
Government Agency
Fiduciary (Estate or Trust)
Partnership
Non-ProtCorporation
PART B - TO BE COMPLETED BY GRANTEE/BUYER
EnterEmployerIdenticationNumber orSocialSecurityNumberoftheGrantee
NameofGrantee
Address
City State Zip Code
County
1.
2.
3.
.
Form5402mustbecompletedforallconveyancesandmustbepresentedatthetimeofrecording.
(Rev8/2018)
REALTY TRANSFER TAX RETURN
AND
AFFIDAVIT OF GAIN AND VALUE
FORM 5402
*DF42718019999*
DF42718019999
STATE OF DELAWARE
DivisionofRevenue
820N.FrenchStreet
P.O.Box8763
Wilmington,Delaware
19899-8763
$
$
$
$
$
$
Reset
Print Form
(Rev8/2018)
PART D - EXEMPT CONVEYANCES
IftransactionisexemptfromRealtyTransferTax,becertainthatalloftheaboveinformation(includingmarketvalueofthereal
estate)iscompleteandaccurateandexplainthebasisfortheexemption:
ThesellerauthorizestheDivisionofRevenueorsuchotherappropriatestateagencyasmaybedesignatedtoobtainanyappropriateor
necessaryfederalincometaxforms,includingtheirattachedschedulesorotherattachments,andanyotherrelatedpapersledbysuchsellerwhich
relatesolelytothesaidrealestatetowhichtitleispurportedtobeconveyedbythedeedorinstrumentbeingrecorded.Delawarelawrequiresan
incometaxreturntobeledforthetaxableyearduringwhichtherewasdispositionofrealpropertywithinthisstate.
SwornandSubscribedbeforeme
onthisdayof ,20
Seller’s Signature
NotarySignature TitleofOcer/Partner