11. Date conveyed
(MM - DD - YYYY)
12. Date recorded
(MM - DD - YYYY)
13. Type of instrument:
Warranty Quitclaim Easement Other
14. The grantor claims no tax is due because (See instructions.):
Conveyance was for no consideration or consideration was less than $2,000.
Exempt under Conn. Gen. Stat. §12-498. Enter exempt code: If exempt code 01 or 09, enter citation or docket #:
Department of Revenue Services
State of Connecticut
PO Box 5035
Hartford CT 06102-5035
OP236 0720W 01 9999
15. Consideration for unimproved land
x 0.0075 =
16. Total consideration for residential dwelling
16a. Portion of Line 16 that is $800,000 or less
x 0.0075 =
16b.
Portion of Line 16 that exceeds $800,000 up to and including $2,500,000
x 0.0125 =
16c. Portion of Line 16 that exceeds $2,500,000
x 0.0225 =
17. Residential property other than residential dwelling
x 0.0075 =
18. Nonresidential property other than unimproved land
x 0.0125 =
19. Property conveyed by a delinquent mortgagor
x 0.0075 =
20. Total State of Connecticut tax due: Add Lines 15, 16a through 19.
Declaration:
I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the best of my knowledge and belief,
it is true, complete, and correct. I understand the penalty for willfully delivering a false return to the Department of Revenue Services (DRS) is a ne of not more than $5,000, or
imprisonment for not more than ve years, or both. The declaration of a paid preparer other than the taxpayer is based on all information of which the preparer has any knowledge.
Name of person signing the return (type or print) Signature Date
Name of grantor’s representative (type or print) Connecticut juris number if applicable Telephone number
Indicate who is signing this return: Grantor Grantor’s attorney Grantor’s authorized agent
OP-236
Connecticut Real Estate Conveyance Tax Return
(Rev. 07/20)
Complete Form OP-236 in blue or black ink only.
-
FEIN
SSN
4. Grantor/seller #1 (last name, rst name, middle initial) Taxpayer Identication Number
Grantor/seller address (street and number) after conveyance City/town State ZIP code
FEIN
SSN
10. Grantee/buyer (last name, rst name, middle initial) Taxpayer Identication Number
Grantee/buyer address (street and number) after conveyance City/town State ZIP code
1. Town 2. Location of property conveyed (number and street)
Amended return
3. Are there more than two grantors/sellers?
Yes
If Yes, attach OP-236 Schedule A - Grantors, Supplemental Information for Real Estate Conveyance Tax Return.
FEIN
SSN
5. Grantor/seller #2 (last name, rst name, middle initial) Taxpayer Identication Number
Grantor/seller address (street and number) after conveyance City/town State ZIP code
9. Is there more than one grantee/buyer or, is the grantee a
partnership, S corporation, LLC, estate, or trust?
Yes
If Yes, attach OP-236 Schedule B - Grantees, Supplemental Information for Real Estate Conveyance Tax Return.
Computation of Tax - Enter consideration for conveyance on the appropriate line. See Instructions.
-
-
Vol.
Pg.
For Town
Clerk Use
Only
Town Code Land Record
6.
Is the grantor a partnership, S corporation, LLC, estate, or trust?
Yes
If Yes, attach OP-236 Schedule A - Grantors
7. Was more than one deed led with this conveyance?
Yes
8. If this conveyance is for no consideration or less than
Federal only State only Both fed. & state None
adequate consideration, which gift tax returns will be led?
______________________________
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