Statement of Reason for Exemption From
Manufactured and Mobile Home Conveyance Fee
Ohio Revised Code section 319.202 and 319.54(G)(3)
Rev. 2/14
Tax list year
Tax district
Type or print all information.
Home located in taxing district
Name on tax duplicate Tax duplicate year
Description of home: Year mfg. Certi cate of title number
Make Serial number Registration number
Following Must Be Completed By Grantee or Grantee’s Representative
1. Grantor’s (seller’s) name Phone
2. Grantee’s (buyer’s) name Phone
Grantee’s address
3. Address of home before transfer
4. Address of home after transfer
5. Tax billing address
6. No conveyance fees shall be charged because the house is transferred:
a) to or from the United States, this state or any instrumentality, agency or political subdivision of the United States or this state.
b) solely in order to provide or release security for a debt or obligation.
c) to evidence a gift, in any form, between husband and wife, or parent and child, or the spouse of either.
d) on sale for delinquent taxes or assessments.
e) pursuant to court order, to the extent that such transfer is not the result of a sale effected or completed pursuant to such order.
f) pursuant to a reorganization of corporations or unincorporated associations or pursuant to the dissolution of a corporation, to the extent that
the corporation conveys the property to a stockholder as a distribution in kind of the corporation’s assets in exchange for the stockholder’s
shares in the dissolved corporation.
g) by a subsidiary corporation to its parent corporation for no consideration, nominal consideration or in sole consideration of the cancellation
or surrender of the subsidiary’s stock.
h) by lease, unless the lease is for a term of years renewable forever.
i) when the value of the home or interest in home conveyed does not exceed $100.
j) of an occupied home being transferred to the dealer of a new home when the former home is traded as part of the consideration for the new
k) to a grantee other than a manufactured or mobile home dealer, solely for the purpose of and as a step in, its prompt sale to others.
l) to or from a person when no money or other valuable and tangible consideration readily convertible into money is paid or to be paid for the
home and the transaction is not a gift.
m) to a trustee acting on behalf of minor children of the deceased.
n) of property sold to a surviving spouse pursuant to Ohio Revised Code section (R.C.) 2106.16.
o) to or from an organization exempt from federal income under Internal Revenue Code section 501(c)(3), provided such transfer is without
consideration and is in furtherance of the charitable or public purpose of such organization.
p) among the heirs at law or devisees, including a surviving spouse of a common decedent, when no consideration in money is paid or to be
paid for the home.
q) to a trustee of a trust, when the grantor of the trust has reserved an unlimited power to revoke the trust.
r) to the grantor of a trust by a trustee of the trust, when the transfer is made to the grantor pursuant to the exercise of the grantor’s power to
revoke the trust or to withdraw trust assets.
s) to the bene ciaries of a trust if the fee was paid on the transfer from the grantor of the trust to the trustee or pursuant to trust provisions that
became irrevocable at the death of the grantor.
t) to a corporation for incorporation into a sports facility constructed pursuant to R.C. section 307.696.
7. Has the grantor indicated that this property is entitled to receive the senior citizen, disabled person or surviving spouse homestead exemption for the
preceding or current year?
Yes No If yes, complete DTE 101.
8. Application for owner-occupancy (2.5% on quali ed levies) reduction. (Notice: Failure to complete this application prohibits the owner from receiving
this reduction until another proper and timely application is led.) Will this property be grantee’s (buyer’s) principal residence by Jan. 1 of next year?
Yes No
I declare under penalties of perjury that this statement has been examined by me and to the best of my knowledge and belief it is a true, correct and
complete statement.
Signature of grantee or representative Date
Neigh. Code
Reset Form
Instructions to Grantee (Buyer) or Representative for
Completing Statement of Reason for Exemption From
Manufactured and Mobile Home Conveyance Fee, DTE 100M(EX)
Complete lines 1 through 8.
WARNING: All questions must be completed to the best of your knowledge to comply with Ohio Revised Code section (R.C.) 319.202.
Persons willfully failing to comply or falsifying information are guilty of a misdemeanor of the rst degree (R.C. section 319.99(B)).
NOTE: This form only applies to the transfer of manufactured or mobile homes where (i) the grantor is not a new manufacturer or mobile
home dealer or (ii) the grantor is a new manufactured or mobile home dealer, but the home was previously titled to an owner who was not
a new manufactured or mobile home dealer.
Line 1 List grantor’s (seller’s) name as shown on the title conveying this home.
Line 2 List grantee’s (buyer’s) name as shown on the title conveying this home and the grantee’s mailing address.
Line 3 List address of home before this transfer by street number and name.
Line 4 List address of home after this transfer (address to which buyer will relocate this home if it is relocated).
Line 5 List complete name and address to which tax bills are to be sent. CAUTION: Each property owner is responsible for paying the
property taxes on time even if no tax bill is received.
Line 6 Check one of the exemptions – (a)-(t) – as appropriate. Keep in mind that a county auditor may inspect any and all documents
in connection with the submission of a conveyance to determine whether the transfer is entitled to exemption. The auditor may
exercise that discretionary power by requiring additional information in the form of af davits, deeds, trust documents, purchase
agreements, closing statements, court orders, resolutions from corporate boards of directors, articles of incorporation, Internal
Revenue Service exemption certi cates, or in any other form deemed necessary by the auditor that suf ciently substantiates
the claim for exemption.
Line 7 If the grantor (seller) has indicated that the home to be conveyed will receive the senior citizen, disabled person or surviving
spouse homestead exemption for the current tax year under R.C. section 4503.065, grantor (seller) must complete DTE form
101 or submit a statement that complies with the provisions of R.C. section 319.202(A)(2), and the grantee (buyer) must submit
such form to the county auditor along with this statement.
Line 8 Complete line 8 (application for owner occupancy – 22% reduction on quali ed levies) only if the parcel is used for residential
purposes. To receive the owner occucpancy tax reduction for next year, you must own and occupy your home as your principal
place of residence (domicile) on Jan. 1 of that year. A homeowner and spouse may receive this reduction on only one home
in Ohio. Failure to complete this application prohibits the owner from receiving this reduction until another proper and timely
application is led.
DTE 100M(EX)
Rev. 2/14
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