DTE 100M

Manufactured or Mobile Home Conveyance Fee Statement of Value and Receipt

If exempt by Ohio Revised Code section 319.54(G)(3), use form DTE 100M(EX).
Instructions to Grantee (Buyer) or Representative for Completing Manufactured or Mobile Home Conveyance Fee Statement of Value

WARNING: All questions must be completed to the best of your knowledge to comply with Ohio Revised Code section (R.C.) 319.202. Persons willfully failing to comply or falsifying information are guilty of a misdemeanor of the first degree (R.C. section 319.99(B)). The county auditor has discretionary power under R.C. section 319.202(A) to request additional information in any form of documentation deemed necessary to verify the accuracy of the information provided by the grantee on the front of the form.

NOTE: This form and fee only apply to the transfer of manufactured or mobile homes where (i) the grantor is not a new manufactured or mobile home dealer or (ii) the grantor is a new manufactured or mobile home dealer, but the home was previously titled to an owner who was not a new manufactured or mobile home dealer.

Manufactured or Mobile Home Conveyance Fee Statement of Value and Receipt

If exempt by Ohio Revised Code section 319.54(G)(3), use form DTE 100M(EX).
All fields marked with * are required and must be filled.
Warning! All taxes must be paid in full to transfer the home.
Click here to access the Franklin County Treasurer's website to check balance due information.
Would you like to fill online or print a blank copy of the PDF?*

Fill OnlinePrint Blank PDF
You have chosen to print a blank PDF form.

To access the application, please follow the link below to download the PDF application form, complete, and sign the application. Completed and signed applications may be submitted by mail to:

Franklin County Auditor
Maufactured and Mobile Homes department
373 S. Hight St, 20th floor
Columbus, OH 43212

Email AUDR_ManufacturedHomes@franklincountyohio.gov

Download PDF for Printing
Select this option to fill out this form interactively so you can print and provide it with payment.

To calculate the fee required to be submitted, refer to Transfer tax & Conveyance fee Calculator. FCA accepts payments in cash, money order, or business check.
Grantee or Representative Must Complete All Questions in This Section
Line 1: List grantor's (seller's) name as shown in the title conveying this home. If there are 3 or more grantors, please list the names on a seperate sheeet and attach below.

Please include the lot number after the street address if applicable.
Is the Grantor an individual(s) or business/public entity?*

Individual(s)Business/Public entity (e.g. a corporation or LLC)
1. Grantor's (seller's) name (1)*

First NameMiddle NameLast NameSuffix
1. Grantor's (seller's) name (2)

First NameMiddle NameLast NameSuffix
1. Grantor's (seller's) Name (1)*
1. Grantor's (seller's) Name (2)
Grantor's Name All
Attach additional grantors here

Cancelof
Phone*
Line 2: List grantee's (buyer's) name as shown in the title conveying this home and the grantee's mailing address. If there are 3 or more grantees, please list the names on a seperate sheet and attach below.
Is the Grantee an individual(s) or business/public entity*

Individual(s)Business/Public entity (e.g. a corporation or LLC)
2. Grantee's (buyer's) name (1)*

First NameMiddle NameLast NameSuffix
2. Grantee's (buyer's) name (2)

First NameMiddle NameLast NameSuffix
2. Grantee's Name (1)*
2. Grantee's Name (2).
Grantee's Name All
Attach additional grantees here

Cancelof
Phone*
Grantee's Address*

Street Address

Street Address Line 2

CityState

Zip Code
Grantee's Address Full
Line 3: List address of home before this transfer by street number and name.

Please include the lot number after the street address if applicable.
3. Address of home before transfer*

Street Address

Street Address Line 2

CityState

Zip Code
Address Before Full
Line 4: List address of home after this transfer (address to which buyer will relocate if this home is relocated).

Please include the lot number after the street address if applicable.
4. Address of home after transfer*

Street Address

Street Address Line 2

CityState

Zip Code
Address After Full
Line 5: List complete address to which bills are to be sent.

CAUTION: Each property owner is responsible for paying the property taxes on time even if no tax bill is received.

Please include the lot number after the street address if applicable.
5. Tax billing address*

Street Address

Street Address Line 2

CityState

Zip Code
Tax Billing Address Full
Line 6: Show any special condition of sale that would affect the purchase price. If any of the special conditions noted are involved, check the appropriate box. Briefly describe other conditions in the space provided.
6. Conditions of sale (check all that apply)

Buyer and seller are relatedPart interest transferTradeGiftOther
Line 7:
a) Enter cash paid for this home (if any).
b) Enter amount of new loan on this home (if any).
c) Enter amount of the balance assumed on an existing loan (if any).
d) Add lines 7a, 7b and 7c.
e) If any portion of the amount paid reported on line 7d was paid for items other than the home, enter the amount paid for those items.
f) Deduct line 7e from line 7d and enter the difference on this line.
g) List lender (if any).
h) In the case of a gift, in whole or part, enter the estimated price that the home would bring in the open market.

The manufactured home conveyance fee is payable on the amount of money reported on either line 7(f) or 7(h).
a) Cash paid (if any)*
Enter cash paid for this home (if any).
b) New debt (loan) amount (if any)
Enter amount of new loan on this home (if any).
c) Loan balance assumed (if any)
Loan balance assumed (if any).
d) Total consideration (amount paid) (add lines 7a, 7b, and 7c)*
Add line 7a, 7b, and 7c.
e) Portion, if any, of total amount paid for items other than the home*
If any portion of the amount paid reported on line 7d was paid for items other than the home, enter the amount paid for those items.
f) Consideration for home on which fee is to be paid (7d minus 7e)*
Deduct line 7e from line 7d and enter the difference on this line.
g) Name of lender (if any)
List lender (if any).
h) If gift, in whole or part, estimated market value of the home
In the case of a gift, in whole or part, enter the estimated price that the home would bring in the open market.
Line 8: If the grantor (seller) has indicated that the home conveyed will receive the senior citizen, disabled person or surviving spouse homestead exemption for current tax year under R.C. section 4503.065, grantor (seller() must complete DTE 101 or submit a statement that complies with the provisions of R.C. section 319.202(A)(2), and the grantee (buyer) must submit such form to the county auditor along with this statement.
8. Has the grantor indicated that this property is entitled to receive the senior citizen, disabled person or surviving spouse homestead exemption for the current tax year?*

YesNo
Click here to access the DTE101 from.
If yes, complete and upload the DTE101 form here.

Cancelof
Line 9: Complete line 9 (application for owner-occupancy reduction on qualified levies) only if the parcel is used for residential purposes. To receive the owner-occupancy homestead tax reduction on qualified levies for next year, you must own and occupy your home as your principal place of residence (domicile) on Jan. 1 of that year. A homeowner and spouse may receive this reduction on only one home in Ohio. Failure to complete this application prohibits the owner from receiving this reduction until another proper and timely application is filed.
9. Application for owner-occupancy (2.5% on qualified levies) reduction. (Notice: Failure to complete this application prohibits the owner from receiving this reduction until another proper and timely application is filed.) Will this property be grantee's (buyer's) principal residence by Jan. 1 of next year?*

YesNo
I declare under penalties of perjury that this statement has been examined by me and to the best of my knowledge and belief it is a true, correct and complete statement.
Signature of grantee or representative*

Clear
Date*

MonthDayYear
Date
Grantee's Email
example@example.com
Please verify that you are human*
Should be Empty:

Manufactured or Mobile Home Conveyance Fee Statement of Value and Receipt

Manufactured or Mobile Home Conveyance Fee Statement of Value and Receipt

Warning! All taxes must be paid in full to transfer the home.

Grantee or Representative Must Complete All Questions in This Section