Reverse Exchange FormStart a New Reverse Exchange Thank you for contacting IPX1031. We look forward to working with you. When completing the below Start a Reverse Exchange form, please provide us with as much information as possible. Please note – you can submit your order form without all the fields completed. We will contact you once your order is received to discuss your upcoming Reverse Exchange transaction. If you have any questions, please email at reverse@ipx1031.com or call Toll Free 888-475-2493.Sales Representative*Sales Representative EmailHiddenRepHiddenRepEmailName of person completing form*Email of person completing form Phone of person completing form*TAXPAYER (EXCHANGER) INFOThe tax owner of the Relinquished Property is termed the “Taxpayer,” and the new property (the “Replacement Property”) will need to ultimately be acquired by the same Taxpayer or through an entity that is disregarded from Taxpayer for federal income tax purposes. Please confirm the vesting of the sale property (e.g. copy of deed when Taxpayer took title).Taxpayer / Entity Name - EXACTLY as on title of the sale property (the “Relinquished Property”)Taxpayer / Entity PhoneTaxpayer / Entity Email Taxpayer / Entity Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Attorney or Tax Advisor First Last Attorney or Tax Advisor PhoneAttorney or Tax Advisor Email Attorney or Tax Advisor Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country RELINQUISHED PROPERTY(IES) - RLQRELINQUISHED PROPERTY COE - RLQCLOSE OF ESCROW DATE MM slash DD slash YYYY Fee QuoteProperty to be parked? Yes NoType of property being sold - RLQ Residential CommericalProperty Address - RLQ Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County - RLQHow long has this property been owned by the Taxpayer? - RLQIs the Taxpayer the only owner on title? - RLQ Yes NoWhat % does Taxpayer own? - RLQDoes the Taxpayer plan on selling to a related party? - RLQ Yes NoDoes the Taxpayer plan on doing any seller financing for the buyer? - RLQ Yes NoIs property under contract - RLQ Yes NoRelinquished Property $ Amounts - RLQPlease provide the approximate $ amounts:Asking Price $Existing Debt $Cash Proceeds (expected at closing) $Additional Relinquished Property? No YesRELINQUISHED PROPERTY 2 COECLOSE OF ESCROW DATE RLQ2 MM slash DD slash YYYY Property Type - RLQ2 Residential CommericalProperty to be parked? - RLQ2 Yes NoOther - RLQ2Name of Property - RLQ2Property Address - RLQ2 Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County - RLQ2How long has this property been owned by the Taxpayer? - RLQ2Is the Taxpayer the only owner on title? - RLQ2 Yes NoWhat % Owned - RLQ2Does the Taxpayer plan on selling to a related party? - RLQ2 Yes NoDoes the Taxpayer plan on doing any seller financing for the buyer? - RLQ2 Yes NoIs property under contract? - RLQ2 Yes NoRelinquished Property 2 $ Amounts - RLQ2Please provide the approximate $ amounts:Asking Price $Existing Debt $Cash Proceeds (expected at closing) $More than 2 Relinquished Properties? No Yes3+ Relinquished Property(ies) - RLQ3+Please provide info for each additional Relinquished Property. Hit the "+" to add each additional Relinquished PropertyAsking Price $Existing Debt (approx) $Cash Proceeds (expected at closing) $Close of Escrow Date Closing Escrow/Title/Attorney Info - Relinquished Property(ies)RLQ Closer NameRLQ Closer Company NameRLQ Closer PhoneRLQ Closer Email RLQ Closer Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code REPLACEMENT PROPERTY(IES) - RPLREPLACEMENT PROPERTY COEESTIMATED CLOSE OF ESCROW DATE RPL MM slash DD slash YYYY Fee QuoteType of property being acquired - RPL Residential CommericalReplacement Property Address - RPL Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County - RPLIs the Seller related to the Taxpayer in any way? - RPL Yes NoWill there be a lender involved? - RPL Yes NoLender Name - RPLLender Company Name - RPLLender Phone - RPLLender Email - RPL Is there a current (less than 6 months old) Phase I Environmental Report available? - RPLWe will require this report if the property is anything other than 1-4 family, residential property. Yes NoReplacement Property Amounts - RPLPlease provide the approximate $ amounts/dates for each Replacement Property. Hit the "+" for each Replacement Property.Purchase Price $Debt Placed on this Property $Improvements (approx value) $Close of Escrow Date Is property under contract? - RPL Yes NoSeller carry-back financing? - RPL Yes NoDo you plan to make improvements to the property while it is parked with IPX1031? - RPL Yes NoEstimated value of improvementsCloser (Attorney/Escrow Officer)- Replacement Property(ies) - RPLCloser (Attorney/Escrow Officer) Name - RPLCloser (Attorney/Escrow Officer) Company - RPLCloser (Attorney/Escrow Officer) Phone - RPLCloser (Attorney/Escrow Officer) Email - RPL Closer (Attorney/Escrow Officer) Address - RPL Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code LLC FORMATION A new LLC must be formed to hold title to the Parked PropertyLLC to be formed by IPX1031® Exchanger/Exchanger's AttorneyLLC Manager Exchanger Preferred State of formation (if any)Preferred Registered Agent** Must be physically located in State of formation. If no agent is named, IPX will designate CT Corporation (additional fee applies).Preferred LLC Name (if any)REQUIRED SET UP DOCUMENTS The following documents will need to be provided to your IPX1031 sales executive.Required Set Up Documents Current Phase I Environmental Report (commercial property only) Copy of Contract for each property Copy of Title Commitment for each property Formation documents if Exchanger is an entityNotes / Additional InfoThe information you provide to IPX1031 will be used to prepare the documents necessary to complete your exchange. Please make sure that the information is accurate and complete. There will be a $250.00 re-drafting fee if it becomes necessary for IPX1031 to redraw exchange documents because IPX1031 was provided with incorrect or incomplete information.
