CODE VIOLATION CLEARANCE FORM DATE: _________________________ SELLER(S) NAME: ____________________________________________________ BUYER(S) NAME: ____________________________________________________ PROPERTY ADDRESS: ____________________________________________________ P.I.N. #: ____________________________________________________ □ □ TYPE OF INSPECTION: POINT-OF-SALE RENTAL DATE OF INSPECTION: ___________________ COST $____________ NAME: __________________________________________________________ INSPECTOR’S □ □ PROPERTY SOLD AS-IS: YES Permit #______________________ NO – HOUSING FINES/LIENS ON PROPERTY: YES / NO (please circle) Ticket No./Lien No. Ticket/Lien Date Amount Amount Paid: _________________________________ Date Paid:__________________ Staff Initials: ________
CODE VIOLATION CLEARANCE FORM DATE: _________________________ SELLER(S) NAME: ____________________________________________________ BUYER(S) NAME: ____________________________________________________ PROPERTY ADDRESS: ____________________________________________________ P.I.N. #: ____________________________________________________ TYPE OF INSPECTION: □ POINT-OF-SALE □ RENTAL DATE OF INSPECTION: ___________________ COST $____________ INSPECTOR’S NAME: __________________________________________________________ PROPERTY SOLD AS-IS: □ YES – Permit #______________________ □ NO HOUSING FINES/LIENS ON PROPERTY: YES / NO (please circle) Ticket No./Lien No. Ticket/Lien Date Amount Amount Paid: _________________________________ Date Paid:__________________ Staff Initials: ________
Exempt_Transfer_Stamp_Requirements_November2013doc.docx