EFTA00089300

New Hampshire
Department of
Revenue Administration

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CD-57-P





*0CD57P1528475*


## REAL ESTATE TRANSFER TAX DECLARATION OF CONSIDERATION REAL ESTATE PURCHASER (GRANTEE)

## STEP 5 - TAX AMOUNT

a) Full price or consideraton for the real estate



b) Divide Line 5(a) by $100



c) Tax rate per $100 at time of transfer

d) Subtotal of Purchaser's tax (Minimum of $20 for all considerations $4,000 or less, per RSA 76-B:1)

## e) Total tax paid to County on behalf of Seller and Purchaser

Are you claiming tax exemption under RSA 78-B:2?

☐ Yes ☒ No

DO NOT file form CD-57-P for transfers specifically exempted from taxation under RSA 78-B:2, except transfers exempted by RSA 78-B:2, IX. Form CD-57-P must be filed for non-contractual transfers although exempted under RSA 78-B:2, IX.

## STEP 6 - TAXPAYER'S SIGNATURE & INFORMATION(Purchaser's Signature is Required)

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

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

## Purchaser 2 Signature

Purchaser 2 Printed Name

Witness Printed Name



Bradford

<table><thead><tr><th></th><th>Granite Reality LLC</th><th>155</th><th>Seaport Blvd</th></tr></thead><tbody><tr><td>Bradford</td><td>12132019</td><td></td><td></td></tr></tbody></table>



12132019


EFTA00089301

New Hampshire
Department of
Revenue Administration

CD-57-P



*0CD57P1538475*


REAL ESTATE TRANSFER TAX DECLARATION OF CONSIDERATION REAL ESTATE PURCHASER (GRANTEE)

Signature Page

STEP 7 - PREPARER'S SIGNATURE & INFORMATION (If prepared by someone other than the Purchaser)

Power of Attorney (POA): By checking this box and signing Step 6, you authorize the preparer listed on this return to act on your behalf for this return only, including entering the book and page numbers and filing this return electronically.

Under penalties of perjury, I declare that I have examined this return 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.)





Granite Reality LLC

Bradford

155



12132019




CD-57-P
Rev 3.0 06/2017


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