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ELECTRONIC RE _ ESTATE "i RANSI'ERR RECEIPT <br /> \O. (:oNSINDI:r. Ri''ii:Ni'0l ii4T\i (' <br /> INS;iit'cTEar s <br /> 1. Grantors and grantees must review this receipt, noting grantor and <br /> grantee responsibilities. <br /> 2. Mail or deliver the following items to: <br /> Dane County Register of Deeds, 210 MARTIN L KING BLVD #110, PO BOX <br /> 1438, MADISON, WI 53701-1438 <br /> • This receipt page, along with a transfer fee of$420.00. <br /> • The deed or instrument of conveyance, along with a recording fee of <br /> $11.00 for the first page and $2.00 for each additional page. <br /> To view the details of the real estate transfer return online, go to <br /> https://ww2.revenue.wi.gov/RETRWebPublic/application. You will need to know the receipt number, the <br /> total value of the real estate transferred, and the last name of one grantor or grantee. <br /> Receipt 107UV. Filed on November 14, 2008 at 5:28 PM. <br /> Value transferred $140,000 Transfer fee $420.00 <br /> Value subject to fee $140,000 Fee exemption number <br /> Grantors Crazy Acres II, LLC <br /> Grenntees Erickson, Roger A. <br /> Tax bill address Roger A. Erickson, 108 North Catlin Street,Edgerton, Wisconsin 53534 <br /> Property Location 657 Liguori Road <br /> Parcels 002/051224297008 (S24/T5N/R12E) (Certified Survey Map No. 12578/1/), <br /> 002/051224380006 (S24/T4N/R12E) (Certified Survey Map No. 12578/1/) <br /> Short legal description Lot 1, Certified Survey Map No. 12578 recorded in Vol. 79 of Certified Survey Maps, Page <br /> 53, as Document No. 4480942, in the Town of Albion, Dane County, Wisconsin. <br /> Grantor responsibilities: Grantors are responsible for paying the proper fee amount—verify the total <br /> property value, fee amount and fee exemption before sending this receipt to the county Register of <br /> Deeds.' <br /> Grantee responsibilities: Grantees assert that this property is not a primary residence2, and that the <br /> property is not subject to weatherization standards with exclusion code "W-1".3 <br /> Preparer Charles V. Sweeney,Axley Brynelson, LLP, 608-257-5661, csweeney @axley.com <br /> Grantor went James A Wileman, 608-884-6141 <br /> Grantee agent <br /> If you have any questions about the Real Estate Transfer Return visit the Real Estate Transfer Web site at <br /> httn://www.dor.state.wi.us/ust/retn.html.You can also contact your County Register of Deeds(see http://www.wrda.org/). <br /> Information on the real estate transfer return is used to administer Wisconsin's laws of income tax,real estate transfers,rental unit energy <br /> efficiency,lottery tax credit and general property tax.The transfer of Wisconsin real estate in a taxable transaction must be reported on your <br /> Wisconsin income tax return.This Is true whether you were a resident,a part-year resident,or a nonresident of Wisconsin.If you are a <br /> nonresident of Wisconsin,you must file Form 1NPR to report the sale. <br /> 1 Penalties for use of an improper exemption are imposed per s.77.26(8),Stats.Penalties for falsifying the property value are imposed per s. <br /> 77.27,Stats. <br /> 2 Penalties for improperly claiming the Lottery&Gaming Credit as Primary Residence are imposed per Chapter Tax 20.19. <br /> 3 Penalties relating to Weatherization claims are imposed per s. 101.122.Stats. <br /> * For more information see Chapter COMM67,s.67.03 and 67.04. <br />