EFTA00089297

New Hampshire
Department of
Revenue Administration



PA-34




*00PR341438475*


## INVENTORY OF PROPERTY TRANSFER

## STEP 6 - PREPARER











EFTA00089298

New Hampshire
Department of
Revenue Administration



PA-34




*OPA34S1418475*


## INVENTORY OF PROPERTY TRANSFER
Signature Page

## STEP 7 - SIGNATURES

Power of Attorney (POA): By checking this box and signing below, you authorize the preparer listed on this document to act on your behalf for this document only, including entering the book and page numbers and filing this document electronically.

## [FAXPAYER'S SIGNATURE & INFORMATION](Purchaser's Signature is Required)

penalties of perjury, I declare that I have examined this return and to the best of my belief it is true, correct and complete.

Purchaser's Signature

MMDDYYYY

Purchaser's Printed Name

te Reality LLC, By: Jeffrey W. Roberts, Manager

Purchaser 2 Signature

MMDDYYYY

Purchaser 2 Printed Name

Purchaser 3 Signature

MMDDYYYY

Purchaser 3 Printed Name

PREPARER'S SIGNATURE & INFORMATION(If prepared by someone other than the Purchaser)

Under penalties of perjury, I declare that I have examined this document and to the best of my belief it is true, correct and complete. (If prepared by a person other than the taxpayer, this declaration is based on all information of which the preparer has knowledge.)

Preparer's Signature (if other than taxpayer)

MMDDYYYY

Preparer's Printed Name (required if POA box is checked)

12/13/2019

Rebecca Russo



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