HomeMy WebLinkAboutL 13018 P 26 i 1111111 1111 111 11 11111 11111 11111 lll����lll ll����lll 1111
I
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 07/03/2019
Number of Pages : 14 At: 11 : 13 :35 AM
Receipt Number : 19-0124140
TRANSFER TAX NUMBER: 18-37042 LIBER: D0001301$
PAGE : 026
District: Section: Block: Lot:
1000 086 . 00 06 . 00 031 . 002
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $0 . 00
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $70 . 00 NO Handling $20 . 00 NO1,
COE $5 . 00 NO NYS SRCHG $15 . 00 NO
EA-CTY $5 . 00 NO EA-STATE $125 . 00 NO
TP-564 $5. 00 NO Notation $0 . 00 �` NO
Cert.Copies $52 . 50 NO RPT $200 . 00 NO
Transfer tax $0 . 00 NO Comm.Pres $0 . 00 NO
Fees Paid $497 .50
TRANSFER TAX NUMBER: 18-37042
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
• JUDITH A. PASCALE
County Clerk, Suffolk County
A•
l
J ON
Number of pages T RECORDED
2019 Jol 03 11:13:35 RM
JUDITH R. PASCALE
CLERThis document will be public FOLY OF
5UFF0Lk; COUNTY
record. Please remove all L D00013018
Social Security NumbersDT# PQ0260 z
prior to recording.
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 FEES
Page/Filing Fee _, Mortgage Amt.
1. Basic Tax
Handling 00 2. Additional Tax
TP-584 Sub Total
Notation '
Spec./Assit.
or
EA-52 17(County) Sub Total_l Spec./Add.
EA-5217(State) r= TOT.MTG.TAX
i Dual Town Dual County
R.P.T.S.A. o?C(7 Held for Appointme
Comm.of Ed. 5. 00 Transfer Tax
• • Mansion Tax
r� ��� ��� The property covered by this mortgage is
ertified Co or will be improved by a one or two
NYS Surcharge 15. 00 family dwelling only.
Sub Total YES or NO
Other _
Grand Total s10" � If NO,see appropriate tax clause on
Pe#�of this ins m /'y
�, "/
4 Dist.l000 19019816 i000 oe600 o600 o3iooa � 5 Community,Preservation Fund
Real Property p T cJ L Consideration Amount$ 0
Tax Service R Lpp A
Agency 02-JUL-19 CPF Tax Due $ 0
Verification
Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD&RETURN TO: Vacant Land X
Law Office of Peter S. Danowski, Jr.
616 Roanoke Avenue TD
Riverhead, NY 11901
TD
TD
Mail to:Judith A. Pascale, Suffolk County Clerk 7 Title CompanV Information
310 Center Drive, Riverhead, NY 11 g01 Co.Name
vu
ww.suffolkcountyny.gov/clerk
Title#
8 Suffolk County Recording & Endorsement PaLre
This page forms part of the attached heed
(SPECIFY TYPE OF INSTRUMENT) made by:
Nancy C. Pearson
The premises herein is situated in
SUFFOLK COUNTY,NEW YORK.
TO In the TOWN of Southold
g"ephfBrantuk and Patricia Brantuk
is wife In the VILLAGE
or HAMLET of
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
Form 8002—Bargain and Sale Dead,with Covenant against Grantor's Acts—Individual or Corporation(Single Sheet)
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT—THIS INSTRUMENT SHOULD
BE USED BY LAWYERS ONLY.
------------------
THIS INDENTURE,made the ?irday of June,in the year 2019
BETWEEN
NANCY C.PEARSON
RESIDING AT 3258 SOUTH HARBOR ROAD,SOUTHOLD,NEW YORK 11971
party of the first part,and
JOSEPH BRANTUK and PATRICIA BRANTUK,his wife,
RESIDING AT 44632 MAIN ROAD,SOUTHOLD,NEW YORK 11971
party of the second part,
WITNESSETH,that the party of the first part,in consideration of Ten Dollars and 001100($10.00)
paid by the party of the second part,does hereby grant and release unto the party of the second part,the
heirs or successors and assigns of the party of the second part forever,
ALL that certain plot, piece or parcel of land,with the buildings and improvements thereon erected,
situate,lying and being in the Town of Southold, at Southold, County of Suffolk and State of New
York,more particularly bounded and described on"SCHEDULE A"annexed hereto.
Being and intended to be the area to be transferred from Parcel"A"to Parcel"B"so as to
carry out a lot line modification,as shown on a certain Boundary Alteration Map prepared for
Joseph Brantuk and Nancy C. Pearson, made by Young and Young, last dated May 16, 2018,
which said map is annexed hereto as"SCHEDULE B"and which such lot line modification
was approved by Resolution oft Town of Southold Planning Board,dated May 7,2019.
401,
With the subtraction of the area described in"SCHEDULE A"herein,the resulting premises of
the party of the first part is more particularly bounded and described on"SCHEDULE C"
annexed hereto and indentified as Parcel"A".
With the addition of the area described in"SCHEDULE A" herein,the resulting premises of the
party of the second part is more particularly bounded and described on"SCHEDULE D"
annexed hereto and identified as Parcel"B".
Reserving however to the grantor herein a right-of-way over a portion of Parcel"B"for the
benefit of Parcel"A"as described in"SCHEDULE E".
A portion of an existing right-of-way over a portion of the premises of the Grantor as described
in Schedule"F"annexed hereto,is to be extinguished.
SUBJECT to the continuing rights of way of Joseph G. Brantuk and Patricia A. Brantuk and
Timothy Coffey over the area described in Schedule"A".
TOGETHER with all right,title and interest,if any,of the party of the first part in and to any streets
and roads abutting the above described premises to the center lines thereof; TOGETHER with the
appurtenances and all the estate and rights of the party of the first part in and to said premises; TO
HAVE AND TO HOLD the premises herein granted unto the party of the second part, the heirs or
successors and assigns of the party of the second part forever,
AND the party of the first part covenants that the party of the first part has not done or suffered
anything whereby the said premises have been encumbered in any way whatever,except as aforesaid.
AND the party of the first part,in compliance with Section 13 of the Lien Law,covenants that the party
of the first part will receive the consideration for this conveyance and will hold the right to receive such
consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement
and will apply the same first to the payment of the cost of the improvement before using any part of the
total of the same for any other purpose.The word "party" shall be construed as if it read "parties"
whenever the sense of this indenture so requires.
IN WITNESS WHEREOF,the party of the first part has duly executed this deed the day and year first
above written.
IN PRESENCE OF: -�
NANCY C.PEARSON
ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE
State of County of SUFFOLK ,ss:
On the 17r day of June, in the year 2019, before me the undersigned, personally appeared NANCY C.
PEARSON personally known to me or proved to me on the basis of satisfactory evidence, to be the
individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that (he)
(she) (they) executed the same in (his) (her) (their) capacity(ies), and that by (his) (her) (their) signature(s) on
the instrument, the individual(s) or the person upon behalf of which the individual(s) acted, executed the
instrument.
Kenneth 8.Zahler
Notary Public,New York
Suffolk No.OIZA4517618
Expires Feb.28.2M
ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE
State of County of ss:
On the day of , in the year 20 before me the undersigned, personally appeared
personally known to me or proved to me on the basis of satisfactory evidence, to be the individual(s) whose
name(s) is (are) subscribed to the within instrument and acknowledged to me that (he) (she) (they) executed
the same in (his) (her) (their) capacity(ies), and that by (his) (her) (their) signature(s) on the instrument, the
individual(s)or the person upon behalf of which the individual(s)acted,executed the instrument.
ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK STATE
•State of County of , ss:
•(or insert District of Columbia,Territory, Possession or Foreign Country)
On the day of , in the year 20 , before me the undersigned, personally appeared
personally known to me or proved to me on the basis of satisfactory evidence, to be the individual(s) whose
name(s) is (are) subscribed to the within instrument and acknowledged to me that (he) (she) (they) executed
the same in (his) (her) (their) capacity(ies), and that by (his) (her) (their) signature(s) on the instrument, the
individual(s)or the person upon behalf of which the individual(s)acted,executed the instrument.
BARGAIN AND SALE DEED RETURN BY MAIL TO
Title No. Peter S. Danowski,Jr.
Nancy C. Pearson to Joseph 616 Roanoke Avenue
Brantuk and Patricia Brantuk Riverhead, NY 11901
his wife
Section: 86
Block: 06
Lot: p/o 31
County or Town: Suffolk/Town of Southold
SCHEDULE E $
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SCHEDULE A
November 9, 2011
JOSEPH BRANTUK & NANCY C. PEARSON
at Peconic, Town of.Southold
Suffolk County, New York
Surveyor's Description - Boundary Alteration Map
Joseph Brantuk & Nancy C. Pearson
Nancy C. Pearson to Joseph Brantuk & Patricia Brantuk
ALL that.certain plot, piece or parcel of land with the buildings and
improvements thereon erected, situate, lying and being at Peconic, Town of
Southold, County of Suffolk and State of New York, being a portion of Lot i,
as shown on Minor Subdivision, "Mohring Enterprises II filed in the Office
of the Town of Southold, more particularly bounded and described as
follows:
BEGINNING at a point on the easterly line of land now or formerly
Little Bear Realty, Inc, at the division line between Lot 1, Minor Subdivision,
"Mohring Enterprises I1" and Lot 2, Minor Subdivision, "Mohring Enterprises
II"•
s
RUNNING thence from said point of beginning North 63 deg. 55 min.
53 sec. East along said division line 26.09 feet to a point;
RUNNING thence through Lot 1, Minor Subdivision, "Mohring
Enterprises I1".the following four (4) courses and distances:
1 . South 09 deg. 25 min. 28 sec. East 70.47 feet,
,2. ' South 59 deg. 59 min. 11 sec: West 290.00 feet,
3. South 30 deg. 00 min. 49 sec. East 15.00 feet,
4- South 59-deg. 59 min. 11 sec. West 82.77 feet to the
approximate high water mark of Richmond Creek;
RUNNING thence along the hig4 water mark of Richmond Creek the
following two (2) tie-line courses and distances.-
1.
istances:1• North 15 deg. 48 min. 44 sec. West 19.09 feet,
2. North 33 deg. 44 min. 29 sec. West 21.54 feet to land now or
formerly Little Bear Realty, Inc.
I
i
Page 2.
November 9, 2011
RUNNING thence along land now or formerly Little Bear Realty, Inc.
the following two (2) courses and distances: 4
1. North 59 deg. 59 min. 11 sec. East 352.17 feet,
2. North 09 deg. 25 min. 28 sec. West 45.68 feet to the point or
place of Beginning.
CONTAINING an area of 0.2679 Acre.
SCHEDULE C
November 9, 2011
JOSEPH BRANTUK & NANCY C. PEARS-ON
at Peconic, Town of Southold
Suffolk County, New York
Surveyor's Description - Boundary Alteration-Map
Joseph Brantuk & Nancy C. Pearson
Parcel A (Confirmation Description Nancy C. Pearson After Alteration)
ALL that certain plot, piece or parcel of land with the buildings and
improvements thereon erected, situate, lying and being at Peconic, Town of
..'Southold, County of Suffolk and'State of-New York, being a portion of uhf,
as shown-on Minor Subdivision, "Mohring Enterprises II" filed in the Office
of the Town of Southold; more particularly bounded and described as
follows:
-BEGINNING at a point on the division line between Lot 1, Minor
Subdivision, "Mohring Enterprises II" and Lot 2, Minor Subdivision,
"Mohring Enterprises II", said point being situate North 63 deg. 55 min. 53
sec. East as measured along said division line 26.09 feet from the easterly
line of land now or formerly Little Bear Realty, Inc.;
RUNNING thence from said point of beginning North 63 deg. 55 min.
53 sec.'East along said division line and along land now or formerly Corey
Creek LLC 542.21 feet to land now or formerly Bradley Anderson &
Francesca Anderson;
RUNNING thence South 27 deg. 01 min. 47 sec. East along land now or
formerly Bradley Anderson & Francesca Anderson 233.34 feet to land now
or formerly Nancy C. Pearson;
RUNNING thence South 60 deg. 31 min. 07 sec. West along land now
or-formerly Nancy C. Pearson 987.29 feet to the approximate high water
mark of Richmond Creek;
RUNNING thence along the high water mark of Richmond Creek the
following four (4) tie-line courses and distances:
1 . North 04 deg. 47 min. 11 sec. West 73.51 feet,
2- North 13'deg. 06 min. 48 sec. West 44.58 feet,
3- North 17 deg. 41 min. 26 sec. West 39.74 feet,
4- North 15 deg. 48 min. 44 sec. West 33.22 feet to land this day
acquired by Joseph Brantuk & Patricia Brantuk;
Page 2
November 9, 2011
RUNNING. thence along said-land the following four (4) courses-and
distances:
1. North 59 deg. 59 min. 11 sec. East 82.77 feet,
2. North-30 deg. 00 min. 49 sec. West 15.00 feet,
3. North 59 deg. 59 min. 11 sec. East 290.00 feet,
4. North 09 deg. 25 min. 28 sec. West 70.47 feet to the point or
place of Beginning.
CONTAINING an area of 4.9628 Acres.
TOGETHER with a certain right of way.
SCHEDULE D
November 9, 2011
JOSEPH BRANTUK & NANCY C. PEARSON
at Peconic, Town of Southold
Suffolk County, New York
Surveyor's Description - Boundary Alteration Map,
Joseph Brantuk & Nancy C. Pearson
'Parcel B (Confirmation Description Joseph Brantuk & Patricia Brantuk .
After Alteration)
ALL'that certain plot, piece or parcel of land with the buildings and
impro_v_ements thereon-erected, situate;-lying and being at-Peconic, Town of,- -- -
Southold, County of Suffolk and State of New York, being Lot 2 and a
portion of Lot 1, as shown on Minor Subdivision, "Mohring Enterprises II"
filed in the Office of the Town of Southold, more particularly bounded and
described as follows:
BEGINNING at a point on the easterly line of land now or formerly
Little Bear Realty, Inc. at the division line between Lot 4 Minor Subdivision,
"Mohring_Enterprises II"-and Lot 2, Minor Subdivision, "Mohring Enterprises
- II",
RUNNING thence from said point-of beginning along land now or
formerly Little Bear Realty, Inc. the following three (3) courses and
distances:
I. •North 09 deg. 25 min. 28 sec. West 333.02 feet,
2. North 09 deg. 10 min. 28.sec. West 148.00 feet,
3. North 09 deg. 40 min. 28 sec. West 51.63 feet to Lot 3, Minor
Subdivision, "Mohring Enterprises II";
RUNNING thence North 78 deg. 07 min. 20 sec. East along Lot 3, Minor'
Subdivision, "Mohring Enterprises II" 483.57 feet to land now or formerly
Corey Creek LLC;
RUNNING thence South 11 deg. 52 min. 40 sec. East along land now or
formerly Corey Creek LLC 403.99 feet to land now or formerly Nancy C.
Pearson;
Page 2
November 9, 2011
RUNNING thence South 63 deg. 55 min. 53 sec. West along Iand now
or formerly Nancy C. Pearson 496.65 feet to the line of-land this day
conveyed by Nancy C. Pearson;
RUNNING thence along said line of land the following four (4) courses
and distances:
I. South-09 deg. 25 min:-28-sec. East 70.47 feet, ---- - -
2. South 59 deg. 50 rein. 11 sec. 1'est 290.00 feet,
3. South 30 deg. 00 min. 49 sec. East. 15.00 feet,
4. South 59 deg. 59 min. 11 sec. West 82.77 feet to the
approximate high water mark of Richmond Creek;
RUNNING thence along the high water mark of Richmond Creek the
following two (2) tie-line courses and distances:
1. North 15 deg. 48 min. 44 sec. West 19.09 feet,
2. North 33 deg. 44 min. .2.9 sec. West 21.54 feet.to land now or
formerly Little Bear Realty, Inc.;
RUNNING thence along land now or formerly. Little Bear Realty, Inc.
the following two (2) courses and distances:
1. North 59 deg. 59 min. 11 sec. East 352.17 feet,
2. North 09 deg. 25 min. 28 sec. West 45.68 feet to the point or
place of Beginning.
CONTAINING an area of 5.5726 Acres.
TOGETHER with and subject to certain rights of way.
s
SCHEDULE E
November 9, 2011
JOSEPH BRANTUK & NANCY
. C. PEARSON
at Peconic, Town of Southold
Suffolk County, New York
Surveyor's Description - Boundary Alteration Map
Joseph Brantuk & Nancy C. Pearson
Right of Way #1 (Right of Way Over Portion of Parcel B for the Benefit of
Parcel A)
ALL that certain plot, piece or parcel of land with the buildings and
improvements thereon erected, situate, lying and being at Peconic; Town-of
Southold, County of Suffolk and State of New York, being a portion of Lot 1,
,
as shown on Minor Subdivision; Mohring Enterprises II filed-irn the Office
of the Town of Southold, more particularly bounded and described as
follows:
BEGINNING at a point on the easterly line of land now or formerly.
Little Bear Realty, Inc. at the division line between Lot 1, Minor Subdivision,
"Mohring Enterprises 1I" and Lot 2, Minor Subdivision, "Mohring Enterprises
II"•
RUNNING thence from said point of beginning North 63 deg. 55 min. .
53 sec. East along said division line 26.09 feet to a point; ..
RUNNING thence along Parcel A the following-two (2) courses and
distances:
I. South 09 deg. 25 min. 28 sec. East 70.47 feet,
2. South 59 deg. 59 min. 11 sec. West 26.71 feet to a point;
RUNNING thence North 09 deg. 25 min. 2.8 sec. West through Parcel B
and along land now or formerly Little Bear Realty, Inc. 72.39 feet to the
point or place of Beginning.
safflxLE F
November 9, 2011
JOSEPH BRANTUK & NANCY C. PEARSON
at Peconic, Town of Southold
Suffolk County, New York
Surveyor's Description - Boundary Alteration Map _
Joseph Brantuk & Nancy C. Pearson
Right of Way#3 (Right of Way Being a Portion of the Right of Way Shawn on Minor Subdivision,
"Mohring Enterprises 11" Over Lot 1 Being Extinguished for Lot 1)
ALL that certain plot. piece or parcel of land with the buildings and improvements thereon
erected, situate, lying and being at Peconic, Town of Southold, County of Suffolk and State of New
York, being a portion of Lot 1, as shown on Minor Subdivision, "Mohring Enterprises 1I" filed in the
Office of the Town of Southold, more particularly bounded.and described as follows:--
BEGINNING
ollows:-BEGINNING at a point on the division line between Lot 1, Minor Subdivision, "'Mohring
Enterprises T and Lot 2, Minor Subdivision, "Mohring Enterprises Il", said point being situate North
63 deg. 55 min. 53 sec. East as measured along said division line 26.09 feet from the easterly line of
land now or formerly Little Bear Realty, Inc.;
RUNNING thence from said point of beginning North 63 deg. 55 min. 53 sec. East along said
division line 26.10 feet to a point;
RUNNING thence through Parcel A the following four(4) courses and distances:
1. South 09 deg. 25 min. 28 sec. East 95.26 feet,
2. South 59 deg. 59 min. I I sec. West 285.00 feet,
3. South 30 deg. 00 min. 49 sec. East 50.00 feet,
4. South 59 deg. 59 min. 11 sec. West 119.31 feet to the approximate high water mark of
Richmond Creek;
RUNNING thence along the high water mark of Richmond Creel: the following two (2) tie-
line cous-ses and distances:
North 17 deg. 41 min. 26 sec. West 28.45 feet,
2. North 15 deg. 48 min. 44 sec. West 33.22 feet to Parcel B;
Page 2
November 9, 2011
RUNNING thence along Parcel B the following four(4)courses and distances:
1. North 59 deg. 59 min. I I sec. East 82.77 feet,
2. North 30 deg. 00 min. 49 sec. West 15.00 feet,
3. North 59 deg. 59 min. I 1 sec. East 290.00 feet,
4. North 09 deg. 25 min. 28 sec. West 70.47 feet to the point or place of Beginning.
Y
INSTRUCTIONS(RP-5217-PDF-INS):www orps slate.ny.us
FOR COUNTY USE ONLY New York Stats Department of
C1.WAS code 7 ? Taxation and Finance
C2.Data Deed Recorded 7 OOffice of Real Property Tax Services
"°" '" T" RP-5217-PDF
C9.Book or toC4.Page 90,E,(r.I__j Lq Real Property Transfer Report(8110)
PROAERTYINFORMATION
1•Location 4432 Route 25
•eTREP ti.uorp anrEk RlMs
Southold
ciTy art Tom Y.rwE 11971
•ARCOOE
t.Buyer Brantuk Joseph
Name
•WTNAYIJCCYeArrY FIRSTUAW
Brantuk Patricia
IAP NAMirmi Wr 1maR k
7.Tax Indicate where future Tex Bills am to be sent
Billing Address If other Man pryer addro.9(al bottom of form)Address hAMUL91PAN. FAyI NAME —
smEEThJ irRANONAM cry OR TOW% erATE t,a OWI
4.Ind(calk,the p roele transfr Of erred oAssessment
the.dud 1 A of Pamela OR ®Pan of a Pan al (Only"Parlors Parcel)Checkas they apply-
Rail IpI
I.Deed �a in vAm she A1L2r3LI011 sLV
Size •FWIRTrcE; ` .�x1. OR Es 4B.SUbehiSlonAPPrMIwas Required for Tiansibr ❑
Size
40.Papal Approved for Subdivision with Mop Provided ❑
Pearson Naflcy C.
e.Seller LA11 yusrcowyAln
Name FN.rmOF
Mel h WK4M+IwY FIYaT NA E
•7.Select the dubrlPuon which most accurately describe.the Check the boxes below es May,apply:
use of the PTP@rly at the pme or ea¢I I.Ownelshlp Type Is Condominium El
part OI Vacan residential lot brdeened I.Now Canswaion on a Vacant Land
IDA.Properly Located within an Agricultural DlsbkJEl
108.Buyer received a dadasurs notes indicating that the properlyIs in an
Agrtcuiheal District Is
SALE INFORMATION 15.Check one or mon of these conditions as applicable to transfer;
A Sale Between Relatives or Former Relatives
11.Sale Contract Date B.Sale beheson Relatud Companies or Partners in Buaineas.
C.One of the Buyers Is also a Sailor
12.Dab of Salelrmnsfer 06/28/2019 D.Buyer or Seller is Govemmsnl Agency or Lending Institution
E.Deed Type not Warranty or Balgaln and Sale(Specify Befewl
F.$ale of Fractional or Leas Nan Fee Interest(Specify Below)
'12.FUII Sale Pricy 0.o1) G.Significant Change In Preporty,Be6voen Taxable Status and Sat Dates
(Full Sale Poco Is me IoW amount paid lar the Property includingH.Sats or Business Is Included In Sale Price
This payment may be in me farm of rash.othergoods. assumption personal Pr�� I.OMOI Unusual Factors Allectnp Sale Price(Spedry Bolowl
mortgages lhx
or oobtgatlons.l Weas&round to aresfred Mdlok doliarr amount of I.
Now
'Comment(s)on Condition:
14.Indicate the value of personal altering boundary-ext:nguishirg part of deeded Bight
property Included In the sat • ) or Nay-BMbLOCE to conitltiana
ASSESSMENT INFORMATION-Data should reflect the latest Fine[Assessment Ro[l and Tax Bill
IN.Year of Assmement Roti tom which Information taken(YY) !7 '17.Total Assessed Value 3,9 00 p/0
•7a.Property Clean 210 _ •1/.School District Name Southold
'20.Tax Map leemlfier(.yRoll Identllsr(s)(a mon than four,suach shoat with additional Identifier(.))
1000-086.00-06.00-p/o 031 .000
CERTIFICATION
I Cerny that all of the limits of lntdmtatidR entered on this form are true and correct(to the but of my knowledge and belief)and I understand that the making of any wtlllul
false statement of matadal fact henln subject me to ths.pypwjalppa ofJhe.penaliaw.reistivo loans making and Hung of false Instruments.
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