Certification of Exempt Status
[Insert Name of Transferor]
[Check One or More]
(1) _____ has sold or exchanged during either of the prior two calendar years,
(2) _____ previously sold or exchanged during the current calendar year,
(3) _____ on the date of closing expects to sell or exchange during the current calendar year,
at least twenty-five separate items of reportable real estate to at least twenty-five separate transferees and each such item, at the date of closing of such item, was or will be held primarily for sale or re-sale to customers in the ordinary course of a trade or business.
The permanent residence (if an individual) or the principal office of the transferor is
The taxpayer identification number of the transferor is _________________.
The real estate (not being reported by virtue of the exempt status of the transferor is
This Certification of Exempt Status is signed under penalties of perjury by the transferor or other person who is authorized to sign a declaration under penalty of perjury on behalf of the transferor as described in Internal Revenue Code Section 6061 and in the Regulations thereunder.
Sworn to and subscribed before me the undersigned authority by _____________
______________________ on this the _____ day of _______________, 20___.
Notary Public in and for ___________
Note, this Certification must be retained by the reporting person for four years following the close of the calendar year in which the closing occurs.
No guidelines are available for this form at this time.