New Hampshire Inventory of Property Transfer

Inventory of Property Transfer
pa-34-2023 (1).pdf
Print Form

New Hampshire
Department of
Revenue Administration

Reset Form

*00PA342311862*

PA-34

00PA342311862

INVENTORY OF PROPERTY TRANSFER
STEP 1 - PURCHASER(S)
Entity Type - (Check One):

Grantee
Individual

(use new primary mailing address)
Joint

Partnership

Corporation

Last Name / Entity

First Name

Last Name / Entity

First Name

Last Name / Entity

First Name

Street No.

Street Name

Trust

State

Holding Company

Phone Number

Apt / Unit

City

LLC

Zip Code + 4 (or Canadian Postal Code)

Email (optional)

STEP 2 - SELLER(S)
Entity Type - (Check One):

Grantor
Individual

(use new primary mailing address)
Joint

Partnership

Corporation

Last Name / Entity

First Name

Last Name / Entity

First Name

Last Name / Entity

First Name

Street No.

Street Name

Trust

Apt / Unit

City

State

LLC

Holding Company

Phone Number

Zip Code + 4 (or Canadian Postal Code)

Email (optional)

STEP 3 - REAL ESTATE
Municipality

Street No.

PA-34
Rev 1.9 07/2023

County

Street Name (If applicable)

Apt / Unit

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New Hampshire

*00PA342321862*

PA-34

Department of
Revenue Administration

00PA342321862

INVENTORY OF PROPERTY TRANSFER
STEP 3 - REAL ESTATE

(continued)

Tax Map

Block

Lot

Acreage
Number of Parcels Purchased
Multi Town Sale?
Yes

If Yes, list municipalities:
No

Property Use
(Check One):
Property Type
(Check One):
Features
(Check One):

Residential

Commercial

Mixed Res / Comm

Industrial

Other

Land Only

Building Only

Land & Building

Condo

Condex

Manufactured Housing

Multi-unit

Timber Rights

Mineral Rights

Waterfront

If multi-unit building, how many units?

Water Access

Land & Manufactured Housing

STEP 4 - DEED
Transfer Date

Type of
Transfer
(Check one):

Recording Date

Warranty

Mortgage

Sheriffs

Tax

Fiduciary

Probate

In Lieu of Foreclosure

Quitclaim

Commissioner's

Sale Price

Page No.

Book No.

Foreclosure

STEP 5 - TRANSACTION DETAIL
Were there any special circumstances in the transfer which suggest that the full price
or consideration of the property was either more or less than its fair market value?
Family Sale

Sheriff's Sale

Government Sale

Business Affiliates

Bank Sale

Abutter Sale

Other

Did the sale transfer 100% interest in the property?

Yes

Did the sale price above include a consideration for non-taxable personal property?
Furnishings

Other

Inventory

Timber

Do you consider the selling price to be fair market value?

Yes

Yes

No

Easement

If Yes, please choose all that apply from
the list below or select “other” and fill in
an explanation.
Life Estate / Trust

Time Share

If no, what % interest transferred?

No

Was the sale price reduced because of a Land Use Change Tax?

Yes

No

Yes

No If yes, indicate value below:

If yes, by what
amount?

No If no,
explain

Have you or will you make improvements to the property after the purchase but before April 1st?

Yes

No

If yes please indicate approximate cost of these improvements:
Occupancy and status of structure

No Structure

Will the property serve as your primary residence?

PA-34
Rev 1.9 07/2023

New Construction (1 yr)
Yes

Previously Occupied

No

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New Hampshire
Department of
Revenue Administration

*00PA342331862*

PA-34

00PA342331862

INVENTORY OF PROPERTY TRANSFER
STEP 6 - PREPARER
Entity

Last Name

Street No.

City

First Name

Street Name

Apt / Unit

State

Phone Number

Zip Code + 4 (or Canadian Postal Code)

Email (optional)

PA-34
Rev 1.9 07/2023

Page 3 of 6

New Hampshire
Department of
Revenue Administration

PA-34

*00PA342341862*
00PA342341862

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.

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.
Purchaser's Signature

MMDDYYYY

Purchaser's Printed Name

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)

PA-34
Rev 1.9 07/2023

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New Hampshire
Department of
Revenue Administration

PA-34

General Questions
Line-By-Line Instructions

DEAR PROPERTY OWNER:
The Department of Revenue Administration is responsible for equalizing the value of property in each municipality. Equalization is used to
accurately apportion county and school district taxes among the cities and towns and to distribute state revenues to the cities and towns. To
equalize property values, the Department of Revenue Administration annually conducts a sales/assessment ratio study for each municipality.
The information provided on the PA-34 form is needed to assist the Department in determining whether a particular sale involved is an “armslength transaction” and should be included in our equalization sales/assessment study. If you have questions regarding this form, please
contact us at (603)230-5920.

WHO MUST FILE
The purchaser, grantee, assignee or transferee of each transfer of real estate or interest in real estate must file the PA-34 form. There are no
exceptions.

WHEN TO FILE
Form PA-34 is due no later than 30 days from the recording date of the deed at the register of deeds or the date of the transfer, whichever is
later.

WHERE TO FILE
A PA-34 form must be filed with the Department of Revenue Administration, P.O. Box 1313 Concord, NH 03302-1313 via the U.S. Post Office or
hand carried to the Department of Revenue Administration at 109 Pleasant Street, Concord, NH, between the hours of 8:00 a.m. and 4:30 p.m.
A copy of the PA-34 form must also be filed with the local assessing officials of the municipality in which the property is located.

NEED HELP?
Questions not covered here may be answered in our Frequently Asked Questions (FAQ) available on our website at www.revenue.nh.gov/ or by
calling Taxpayer Services at (603) 230-5920, Monday through Friday, 8:00 am to 4:30 pm. All written correspondence to the Department should
include the taxpayer name, taxpayer identification number, the name of a contact person and a daytime telephone number. Individuals who
need auxiliary aids for effective communications in programs and services of the New Hampshire Department of Revenue Administration are
invited to make their needs and preferences known. Individuals with hearing or speech impairments may call TDD Access: Relay NH 1-800-7352964.

NEED FORMS?
To access additional forms, please visit our web site at www.revenue.nh.gov/ or call the Forms Line at (603) 230-5001.

LINE-BY-LINE INSTRUCTIONS
Please PRINT legibly or type all information.

STEP 1 - Purchaser(s)
First select the applicable Entity Type of the purchaser.
Enter the full name and address (use new primary mailing address) of the purchaser(s), grantee(s), assignee(s) or transferee(s). Email address is
an optional field. Please attach an additional PA-34 for more than three purchasers.

STEP 2 - Seller(s)
First select the applicable Entity Type of the seller.
Enter the full name and address (use new primary mailing address) of the seller(s), grantor(s), assignor(s) or transferor(s). Email address is an
optional field.

STEP 3 - Real Estate
Property Location and Description: Enter the municipality, county, street number, street name, and apartment/unit number where
the property is located. Provide the tax map, block and lot (parcel identification number) used by the municipality to identify the
parcel as well as the area in acres and the number of parcels purchased. If the sale is a multi-town sale, please enter all of the
municipalities where parcels are located. Parcel identification numbers are available at local assessing office.
Property Use: Select the primary use of the parcel; only one option may be selected.
Property Type: Select the property type of the parcel; select all that apply.
Features: Identify if the parcel is waterfront or has water access, if applicable. Only one option may be selected. For multi-unit
buildings please indicate the number of units.

STEP 4 - Deed
Enter the transfer date, recording date and Book and Page numbers assigned by the County Register of Deeds, along with the sale price (actual
amount paid). Please indicate the deed type for the transactions, only one option may be selected. Please note that Book and Page numbers
are required and the form will be returned if these fields are left blank.
PA-34
Rev 1.9 07/2023

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New Hampshire
Department of
Revenue Administration

PA-34

Line-By-Line Instructions

STEP 5 - Transaction Detail
• Question 1: Check the appropriate box as to whether there were any special circumstances that would suggest the full price or
consideration of the property was either more or less than its fair market value. If “yes,” please choose all reasons that apply or select “other”
and provide a detailed explanation.

• Question 2: Check the appropriate box as to whether the sale transferred 100% interest in the property. If “no,” indicate the percentage of
interest in the property that was transferred.
• Question 3: Check the appropriate box as to whether the sale price included a consideration for non-taxable personal property. If “yes,”
indicate the approximate value of furnishings, inventory, timber and/or other property (appliances, minerals, boats, equipment, inventory of
a business, etc.) in the appropriate box.
• Question 4: Check the appropriate box as to whether the sale price was reduced because of a Land Use Change Tax per RSA 79-A:7. If “yes,”
please specify the amount.
• Question 5: Check the appropriate box as to whether you consider the selling price to be fair market value. If “no,” please explain the
reason(s) why.
• Question 6: Check the appropriate box as to whether the grantee has made or intends to make improvements to the property after the
purchase but before April 1st. If “yes,” please indicate the approximate cost of these improvements. Do not include improvements made by
the grantor prior to establishing the sale price.
• Question 7: Check the appropriate box as to the occupancy and status of the structure.
• Question 8: Check the appropriate box as to whether the property will serve as your primary residence.

STEP 6 - Preparer
If this form was filled out by someone other than the purchser, please enter the full name, entity, address, identification number, phone
number and email address (optional) of the preparer.

STEP 7 - Signatures (Paper Form)
• Power of Attorney (POA): By checking the POA box, and signing below, the taxpayer(s) authorizes the preparer listed in Step 6 to act on your
behalf for this document only, including entering the Book and Page numbers and filing this document. This is a limited POA for this
document only. If a Purchaser does not authorize the POA then a separate PA-34 must be filed.
• Purchaser's Signature and Information: The Form must be signed in ink and dated by the Purchaser(s).
• Preparer's Signature and Information: If the Form was prepared by someone other than the Purchaser(s), the Form must be dated and signed
in ink by the preparer. The preparer's printed name is also required if the POA box is checked.

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