Land and Buildings Transaction Tax Return

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May 2018 1 Land and Buildings Transaction Tax Return Your LBTT Return Guidance notes can be found on our website www.revenue.scot, these will help you to complete this return accurately. You must use black ink to complete this return form and write in BLOCK CAPITALS If you make a mistake on this return form, please do not use correction fluid. Cross out the error and rewrite If a question does not apply to you, leave the answer field blank The final tax amount should be rounded down to the nearest pound - ignore the pence If you require additional space for further buyers, sellers or properties; please complete an 'Additional Details' form. If Additional Dwelling Supplement is due, please complete Additional Dwelling Supplement (ADS) form. These are available at www.revenue.scot/land-buildings-transaction-tax/forms. Where these forms have been completed, they form part of the tax return Once you have completed this return and any accompanying forms, please check that all information is correct and complete before signing the declaration - any omissions may lead to the forms being returned to you. In addition, any omission, error or inaccuracy in this return form may render you liable to financial penalties and/or prosecution This return form must be sent with an accompanying cheque for the amount of tax you have calculated is due made payable to 'Revenue Scotland', to: Registers of Scotland, Meadowbank House, 153 London Road, Edinburgh, EH8 7AU (DX555400, Edinburgh 15). For any further advice and assistance, please see the FAQs on our website, or alternatively contact Revenue Scotland on 0300 020 0310 (Monday to Friday 9.00-16.00. Please note that lines will be closed from 9.00-10.00 every Thursday for staff training). About the Transaction Description of transaction Conveyance or transfer Lease Is Additional Dwelling Supplement (ADS) due on this Transaction? (If Yes complete the Additional Dwelling Supplement (ADS) form). Type of property Residential Non-residential Is this transaction pursuant to a previous option agreement? Effective Date Relevant Date Date of contract or conclusion of missives Does this transaction include any element of exchange or part exchange? Is this transaction linked to any others? Is this transaction included in a package with transactions elsewhere in the UK, but outside of Scotland?

May 2018 2 About the Buyer - Private Individuals and Representatives Dr Other Buyer surname About the Buyer - Private Individuals and Representatives Additional Buyer Dr Other Buyer surname Buyer first name(s) Buyer first name(s) Telephone number Telephone number National Insurance Number, where applicable If buyer (1) has no UK reference, give a reference from the country in which buyer (1) is based where reference was issued Is the buyer acting as a private individual? Is the buyer acting as a trustee? Put 'X' in one b ox Is the buyer acting as representative partner? Name of partnership or trust

May 2018 3 About the Buyer - Incorporated Bodies About the Buyer - Incorporated Bodies Additional Buyer Legal name Legal name Is the buyer acting as a trustee? Is the buyer acting as a trustee?

May 2018 4 About the Buyer's Agent Agent name Agent DX number & exchange Agent telephone number Agent email Agent reference I, agent for the buyer(s), confirm that I have authority to deal with all matters relating to this transaction on behalf of my client(s) About the Seller - Private Individuals and Representatives About the Seller Private Individuals and Representatives Additional Seller Dr Other Seller surname Dr Other Seller surname Seller first name(s) Seller first name(s)

May 2018 5 About the Seller Incorporated Bodies About the Seller - Incorporated Bodies Additional Seller Business name Business name About the Seller's Agent Agent name Agent DX number & exchange Agent telephone number Agent email

May 2018 6 About the Property Local authority number Title number (Enter the code from the guidance notes) Parent title number Is Additional Dwelling Supplement due on this property? About the Conveyance or Transfer Is this transaction part of the sale of business? If this transaction is part of the sale of business, please say if the sale includes any of the following: Stock Goodwill Moveables Other What is the total consideration in money or money's worth, including any VAT actually payable for the transaction notified? If the total consideration for the transaction includes VAT please state the amount of VAT Enter the total amount of consideration relating to the non-chargeable assets Remaining chargeable consideration Total consideration or value in money or money's worth, including VAT paid for all of the linked transactions About the Lease Start date as specified in the lease End date as specified in the lease Typical annual rent of lease, including VAT where applicable Total premium (grassum) payable Relevant rental figure Net present value upon which tax on rent is calculated Total amount of tax due - premium (grassum) Total amount of tax due - NPV

May 2018 7 About the Calculation Are you claiming relief? Is any part of the consideration contingent or dependent on uncertain future events? Type Amount Have you agreed with Revenue Scotland you will pay on a deferred basis? Type Amount (Select code of relief from the guidance) LBTT less reliefs (excluding Additional Dwelling Supplement) If you answered Yes, enter the deferral reference provided by Revenue Scotland Additional Dwelling Supplement less relief/repayment Total amount of tax due for this transaction DECLARATION If you give false information, you may face financial penalties and/or prosecution. OR 'I, the buyer, declare that this return is, to the best of my knowledge, correct and complete.' 'I, the agent of the buyer(s), having been authorised to complete this return on behalf of the buyer(s): (a) certify that the buyer(s) has/have declared that the information provided in the return, with the exception of the relevant date, is to the best of their knowledge, correct and complete; and (b) declare that the relevant date provided in the return is, to the best of my knowledge, correct.' SIGNATURE OF BUYER 1 OR AGENT SIGNATURE OF BUYER 2 (IF APPLICABLE) PRINT NAME PRINT NAME DATE DATE General Data Protection Regulation Revenue Scotland collects personal data to support the collection and management of the devolved taxes for which it is responsible. We may also use information you provide to protect the revenue against tax fraud and avoidance. Where the law permits or requires it, we may also get personal data about a taxpayer from third parties, or give personal data to third parties. These third parties include, among others: public bodies (such as HMRC, the Keeper of the Registers of Scotland and the Scottish Environment Protection Agency), tribunals, courts, law enforcement agencies (such as Police Scotland and the Crown Office and Procurator Fiscal Service), and our suppliers and service providers. Further information on our data policies can be viewed on our website: www.revenue.scot/legal-notices