Statement of Reason for Exemption From Real Property Conveyance Fee
Ohio Revised Code section 319.202 and 319.54(G)(3)
DTE 100EX
Rev 1/14
Date Co. no. 13 Number
Land Bldg. TotalInstr. Tax District No. Tax list
FOR COUNTY AUDITOR USE ONLY
DTE Code Number ___________________________________ Split/New Plat Remarks: ____________________
Property Located in ___________________________________________________________________ Taxing District
Name on Tax Duplicate _________________________________________________ Tax Duplicate Year ___________
Acct. or Permanent Parcel No. ___________________________________________ Map Book _____ Page ________
Description: _____________________________________________________________________________________
The Following Must Be Completed by Grantee or His/Her Representative
Type or print all information. See instructions on reverse.
1. Grantor’s name ____________________________________________________________ Phone_________________________
2. Grantee’s name ____________________________________________________________Phone ________________________
Grantee’s address ________________________________________________________________________________________
3. Address of property ________________________________________________________________________________________
4. Tax billing address _________________________________________________________________________________________
5. No conveyance fees shall be charged because the real property 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. (Must include adavit of facts)
___c) to conrm or correct a deed previously executed and recorded.
___d) to evidence a gift, in any form, between husband and wife, or parent and child, or spouse of either.
___e) on sale for delinquent taxes or assessments.
___f) pursuant to court order, to the extent that such transfer is not the result of a sale eected or completed pursuant to such order.
___g) 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. (Must include adavit of facts)
___h) 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.
___i) by lease, whether or not it extends to mineral or mineral rights, unless the lease is for a term of years renewable forever.
___j) when the value of the real property or interest in real property conveyed does not exceed $100.
___k) of an occupied residential property being transferred to the builder of a new residence when the former residence is traded as part of the
consideration for the new residence.
___l) to a grantee other than a dealer in real property, solely for the purpose of and as a step in, its prompt sale to others.
___m) 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
real estate and the transaction is not a gift. (Must include adavit of facts)
___n) to an heir or devisee, between spouses or to a surviving spouse, from a person to himself and others, to a surviving tenant, or on the death of
a registered owner.
___o) to a trustee acting on behalf of minor children of the deceased.
___p) of an easement or right-of-way when the value of the interest conveyed does not exceed $1,000.
___q) of property sold to a surviving spouse pursuant to Ohio Revised Code section (R.C.) 2106.16.
___r) 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.
___s) 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 real property.
___t) to a trustee of a trust, when the grantor of the trust has reserved an unlimited power to revoke the trust.
___u) 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.
___v) to the beneciaries 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.
___w) to a corporation for incorporation into a sports facility constructed pursuant to R.C. section 307.696[307.69.6].
___x) between persons pursuant to R.C. section 5302.18.
___y) from a county land reutilization corporation organized under R.C.section 1724 to a third party.
6. 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 form DTE 101.
7. Has the grantor indicated that this property is qualied for current agricultural use valuation from the preceding or current tax year? Yes No
If yes, complete form DTE 102.
8. Application for owner-occupancy (2.5% on qualied 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 principal residence by Jan. 1 of next year?
Yes No If yes, is the property a multi-unit dwelling? Yes No
9. Is this property leased or otherwise rented to tenants solely for residential purposes? Yes No If yes, new owner must complete and submit a
Rental Registration Form to the County Auditor within 60 days (including weekends and holidays) of the date of this transfer to avoid a penalty on
their tax bill.
I declare under penalties of perjury that this statement has been examined by me and to the best of my knowledge and belief is true, correct and complete statement.
______________________________________ ________________________________________________ ________________________________
Printed Name of Grantee or Representative Signature of Grantee or Representative Date
INSTRUCTIONS TO GRANTEE OR REPRESENTATIVE FOR COMPLETING
STATEMENT OF REASON FOR EXEMPTION FROM
REAL PROPERTY CONVEYANCE FEE, DTE FORM (100) EX
COMPLETE LINES 1 THROUGH 9 IN BOX ONLY
WARNING: All questions must be completed to the best of your knowledge to comply with Ohio Revised Code (R.C.) sec-
tion 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)).
LINE 1 List grantor’s name as shown in the deed or other instrument conveying this real property. Phone number
is optional.
LINE 2 List grantee’s name as shown in the deed or other instrument conveying this real property along with
grantee’s address. Phone number is optional.
LINE 3 List address of property conveyed by house number and street.
LINE 4 List complete address to which tax bills are to be sent if dierent than address of property conveyed.
CAUTION: EACH PROPERTY OWNER IS RESPONSIBLE FOR PAYING THE PROPERTY TAXES ON
TIME EVEN IF NO TAX BILL IS RECEIVED.
LINE 5 Check one of the exemptions (a) - (y), 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 adavits, deeds, trust documents, purchase agreements, closing statements,
court orders, resolutions from corporate boards of directors, articles of incorporation, Internal Revenue
Service exemption certicates, or any other form deemed necessary by the auditor to suciently substantiate
the claim for exemption.
LINE 6 If the grantor has indicated that the property to be conveyed will receive the senior citizen, disabled person
or surviving spouse homestead exemption for the preceding or current tax year under O.R.C. section
3232.152(A), the grantee and grantor must complete DTE FORM 101, or submit a statement which complies
with the provisions of O.R.C. section 319.202(a)(2) and submit such form to the county auditor along with
this conveyance fee statement.
LINE 7 If the grantor has indicated that the property to be conveyed was qualied for current agricultural use
valuation for the preceding or current tax year under O.R.C. section 5713.30, the grantor must complete
DTE FORM 102, or a statement that complies with O.R.C. section 319.202 (B)(2), and submit such form
to the county auditor along with this conveyance fee statement.
LINE 8 Complete line 8 (Application for Owner Occupancy - 2
1/2
% reduction on qualied levies) only if the parcel is
used for residential purposes. To receive the owner occupancy 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.
LINE 9 Answer this question “Yes” if this property is leased or otherwise rented to tenants solely for residential
purposes. The new owner must complete and submit a Rental Registration Form to the County Auditor
within 60 days (including weekends and holidays) of the date of this transfer to avoid a penalty on their tax
bill.
