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7/24/23,9:34 AM eRETR Public View—Receipt <br /> Electronic Real Estate Transfer Receipt 11111111111 <br /> Wisconsin Department of Revenue 7LN3V <br /> Instructions <br /> 1. Grantors and grantees must review this receipt, noting grantor and grantee responsibilities <br /> 2. Mail or deliver the following items: <br /> Burnett County Register of Deeds, 7410 COUNTY RD K, RM 103, SIREN, WI 54872-9067 <br /> • This receipt page and a transfer fee of$45.00 <br /> • The deed or instrument of conveyance and a recording fee of$30.00 (regardless of the <br /> number of pages) <br /> To view real estate transfer return details online, visit: <br /> https://ww2.revenue.wi.gov/RETRWebPublic/application. You will need your receipt number, total value of <br /> real estate transferred, and the last name of one grantor or grantee. <br /> Receipt 7LN3V. Filed July 21, 2023, 11:40 AM - Burnett County. Conveyance date 2023-07-01. <br /> Value transferred $15,000 Transfer fee $45.00 <br /> Value subject to fee $15,000 Fee exemption number <br /> Grantors Sobaski, William James and Gail Darice <br /> Grantees Sobaski, Robert Lowell and Teri Ann <br /> Tax bill address Robert Lowell and Teri Ann Sobaski, 2601 Pine Knoll Road, Danbury, Wisconsin 54830 <br /> Property Location Pine Knoll Road (Town of Scott) <br /> Parcels 07-028-2-40-14-05-5 05-003-011000 (S5/T4ON/R14W) <br /> Lot 1 of Certified Survey Map No. 5278, recorded as Volume 30, Pages 82-83 as <br /> Legal description Document No. 481847, of Section 5,Township 40 North, Range 14 West,Town of <br /> Scott, Burnett 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 residence. <br /> Preparer Gail D. Sobaski, (651) 808-4190, gdsbjs@gmail.com <br /> Grantor agent <br /> Grantee agent <br /> If you have questions on the Real Estate Transfer Return(RETR),visit the Wisconsin Department of Revenue's Real Estate Transfer Fee web <br /> page at: revenue.wi.gov/retr/index.html,or contact your County Register of Deeds.To locate your Register of Deeds,visit: wrdaonline.org. <br /> Information on a real estate transfer return is used to administer various Wisconsin laws, including: income tax, real estate transfers,rental <br /> unit energy efficiency, lottery tax credit,and general property tax.Whether you are a resident,part-year resident,or non-resident,you must <br /> report the transfer of Wisconsin real estate in a taxable transaction on your Wisconsin income tax return.If you are a non-resident,you must <br /> file Form 1NPR to report the sale. <br /> Penalties imposed under the following Wisconsin Statutes or Administrative Code: <br /> Using an improper exemption-sec.77.26(8),Wis.Stats.;falsifying the property value-sec. 77.27,Wis.Stats.; <br /> improperly claiming lottery and gaming credit as primary residence-chapter tax 20.12,Wis.Adm.Code. <br /> Weatherization program under sec. 101.122,Wis.Stats.,no longer exists. <br /> https://ww2.revenue.wi.gov/RETRWebPublic/application?F3=F3 i/1 <br />