ATET4-2013
STATE OF SOUTH CAROLINA )
COUNTY OF
) AFFIDAVIT FOR TAXABLE OR EXEMPT TRANSFERS
PERSONALLY appeared before me the undersigned, who being duly sworn, deposes and says:
1. I have read the information on this affidavit and I understand such information.
2. The property was transferred by
to on .
3. Check one of the following: The deed is
(A)
(B)
(C)
subject to the deed recording fee as a transfer for consideration paid or to be
paid in money or moneys worth.
subject to the deed recording fee as a transfer between a corporation, a
partnership, or other entity and a stockholder, partner, or owner of the entity,
or is a transfer to a trust or as distribution to a trust beneficiary.
exempt from the deed recording fee because (See Information section of
affidavit):
(explanation required)
(If exempt, please skip items 4-7, and go to item 8 of this affidavit.)
If exempt under exemption #14 as described in the Information section of this affidavit, did the
agent and principal relationship exist at the time of the original sale and was the purpose of this
relationship to purchase the realty?
Check Yes or No _
4. Check one of the following if either item 3(a) or item 3(b) above has been checked. (See
Information section of this affidavit):
(A)
(B)
(C)
The fee is computed on the consideration paid or to be paid in money or
moneys worth in the amount of
The fee is computed on the fair market value of the realty which is
.
The fee is computed on the fair market value of the realty as established for
property tax purposes which is .
5. Check YES
or NO _
to the following: A lien or encumbrance existed on the land,
tenement, or realty before the transfer and remained on the land, tenement, or realty after
the transfer. If YES,” the amount of the outstanding balance of this lien or encumbrance is
.
6. The deed recording fee is computed as follows:
(A) Place the amount listed in item 4 above here:
(B) Place the amount listed in item 5 above here:
(If no amount is listed, place zero here.)
(C) Subtract Line 6(b) from Line 6(a) and place the result here:
ATET4-2013
7. The deed recording fee is based on the amount listed on Line 6(c) above and the deed
recording fee due is .
8. As required by Code Section 12-24-70, I state that I am a responsible person who was
connected with the transaction as .
9. I understand that a person required to furnish this affidavit who willfully furnishes a false or
fraudulent affidavit is guilty of a misdemeanor and, upon conviction, must be fined not
more than one thousand dollars or imprisoned not more than one year, or both.
Responsible Person Connected with the Transaction
Print or Type Name Here
Sworn this day of 20
Notary Public for
My Commission Expires:
, 20
December
December
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