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CONIIAY YOU. LAWY" IHfO&I SIGIt8tG 1lIIS '''STIlUMINT - nws IIIS'n.UMIIIT ItIQULD .. USID .Y LAWYIU ONLY
THIS 1NDE.N1'URE, mode on D:. 'I:..::::.\=..-, . .Qq. .Q.OC>Y
~ BRUCE V. KELLER. RANDALL C. KELLER AND VALERIE C. STEWART.
TRUSTEES OF THE RUBY C. KELLER 1993 QUALIFIED PERSONAL RESIDENCE
TRUST, RESIDING AT 301 CYNTHIA COURT. PRINCETON, NJ 08540
-.
....,. of doe iii.- ...... ...d
BRUCE V. KELLER. RESIDING AT 301 CYNTHIA COURT. PRINCETON. NJ 08940.
RANDALL C. KELLER,RESIDING AT 757 PARKRIDGE DRIVE. CLAYTON. NC 27527
ANO VALERIE C. STEWAR.T.".RESIDjNG..AT 55 BILTMORE CIRCLE~ HUNTHWTON
STATION, NY 11746. AS TENANTS-IN-COMMON.
"'''Y 01 ,he _d .......
WITNES!IEnI, the. the .....y of ..... Ii.. ?~.riOD of TeA DoIIa.. ...d ........ .aIuahIe coaaidantiwa
pIOid by .he pari, of .... _d ...... ...... . "-"" reIe_ un'o the paI1y of doe -.I ...... doe heir.
or .Ul -: '-n.Dd........ of. the .-"" of the -. ....-.
~ .hat _ill plot, Pi- or ...rcel of Iand!~' ~-" huildiAp .nd impro_ "-- ended, oilu.1e.
Iyj"" and baia" in the '. r f.1~ [ .
SEE 'EXHIBIT ~~:rr,,~ HERETO
~
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TOGETHER with .11 ri(lbt, dde and inlerat. if "1)"0 ul the pliny of the finl~~_l in and 10 any .trccllt .nd
road. .bu.niDB the .boYel ducribecl premu. 10 tIw center lin" thereof. TOGETHER with lhe a..pPUI1eaaru:ea
.ad .11 ..... ....... .nd ril!fdo 01 the .....y of Ibe Ii.. ..... ia and '0 ..id .......;..; TO HAVE AND TO HOLD
the p~mme. herein ,granted unto lhe pliny of ~he MCond pIIrL the heir. or sucxeuon and ...i,n. of the ...rty of
lhe eecond pa...t fo......... ..
AND Ibe party of the first part COVeIWJI" that the IMItJ of ~ tint part _ not done or suffered anythinlC whel'eby
the said prcllftilea haft been encurnbered in any w.y whalever. Peept a. uoreuid.
AND the party of the first pIIrt. in compliance .lIh Section 13 of lhe Lien Law, covenanla thai the party of the. firat
pe...t will receive Ihe conaideratioa for thi. COIIveyanee .nd will hold the npt to receive auc:h conaideration ...a
. lruo' lundto he .pp1ied Ii,.. for ..... pu~ of payinl1he cool vf the ImpnlveJllCA' and wiD .pp1y the ....... Ii.. to
tbe paymcat of the COld of the il1lproYemllnt Wore ai... any part of the leal" of Ilh...me for any other JlUrpoR.
The word .I.-rty" .aI. be c~ .. if it ....d "part." ._never the ten.e of rhi. indenture au reqUIree..
IN. WlTNE5S WHEREOF, ,he PO'" of the fir.. ..... h.. duly e...c:u Ihm deed .he ~r Ii,., .......,.
wraUen. .. . . .;;--'& _ ~
IN paESEPfCE uF: .' ~~TEE
~""YGIIIC."'ATI!(RPL__
Stat. of Ne. York,Couat)' of ~Wd.'V.- .a..
On ~". 2..\,.2.Dc:>4 befoce me. !be underoi~
pen<llllllIy-- VALERIE CT STEWART
pe_y _tomo<<JIIUII'OdlDmoem!be_ofllllioftlc-
IDly ...ideo_ 10 be .... iDdividuol(') _ ---<.) io (..)
_to....___...l.uu.. '.. 'IDmo_
ho'lIhdJbey __ .... _ in __...... '. '1)(ieo).
_ _ by h1_ oipaJn(o) em.... __....__
vidllll!C.).<<.... _ __ boIuIIf of _ .... dII,.~'I(.)
........-~_,~. . -
(" ~"t..'
RY PIJllLIC. _ "'New Yolk LA
.No.1~44 ", NOT
-.... iii ~..... No.
_ oflle.M.......-~"'II\'.':.'\'VIiU'f "'!.:
On tlo.~ I II I 1~":''' before me, .... undenI~
pe.-.llyoppeBftld BRUCE V. KELLER
penian8l1y _ ID mo <<JIIUII'Od 10 mo en.... _ of_
fOClDry .._ 10 be .... iadivld....I(.) _ -<01 io c..)
su~bed ID.... widJia _ "'" -1edFd ID mo
_ heloha'lIIey _led.... _ in h_ c:opKily(ieo).
__by_ir..-,re(.)oa.... -......iadi-
_1.).<<.... _ __ - ofwhlcb .... iJidIvlcIuI(.)
1ICII:d,.""""""'....i_----oI-
=;:.._~;;-b.:fu.~~~l"...t.l.... &ol'~
(illMnay_ ...__y ...~.....,.
-- _~~~t. 0'
c..-:;..... .......re. "J/-..11"t
.....,.a. IIIIIl ... ....
1PInr CaYlal...... .Ac&n.... CaaIftOll". Acn
Trru No.
ro
~ "'M~NI' BY ....CI_"O ..vi
.18.
State of
Counl, of
I""
On
personally oppeated
befo,e me. rbe undenigncd.
!be oubocribina wi1JlCU(eo) 10 !be forepn, in.....ment, wilb
_ I _ penanoJly ll<llpIIliIlted. w..... beina by mo claly
........ did depooe _ NY _ helsbe1d1ey _lsl in ,if'"
~ tiff ,.~ ill III . ri~ ma..Ir "., ~ .." ~ .........
11__
ell JOSIlPHI!R
Y PUBLIC, State of New York
IJ04980744
Qyalified in State of New York
.Commission Exp1res April 29. 2007
.xec..... Ibe _: ..,.) _ IIid witnea(ea) .. Ibe _ lime
subocn1Jed bislbel1_ _ls) IS. wi_lea) _
( 0 41........."... ftri: "'- ""dlJlfW po,,*-I ... rr-.__...
_,-."",.....",.". . 1. ..... And........ aabKribins
wilaell(ea) _ oudJ .. __ before .... a_pod ill
~_ -. :" \.~/.i"J'~
....., __I gl:1!r _ .
i,1-"""'''
~.....1JI_
MIlk 81_" . _ .-yPUIIIC
\MJ] . ...... JA,."--.......f..~
....- -
""~I. -~ .
.........p....~.r & .......-..-or........
SECI1IlN
BLOCIt
UYr
OOUNTY OR TOWN
IlETUIUf BY MAIL TO,
Zip No.
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-.-----
.... ' ...
.'1,..
-"__II1'''TS__
Stale 0' New York, Count,. or ...:
On
~Iy--
before me. the UIIlIon.iplod.
poIWXIOIly - 10 me or ~.. me on _1lIIiI 0I111isC1c-
IOIy evidence 10 be die individulII(l) _ -..:(1) is <-I
...- II> die within inIaumenIand ~*"'"" III me dull
""'--"" ..--' _ ...... iD hlol1..J\1wb ~...).
- - by - .........'"'(1) em _ u..-....__
vidu8!(s). or - _ _ _ '" wIIidI _ iDdivlduaI(l)
-. elleCUllOd the i-..-.
f~~lIWtIo.JJfu"''''w..I~...LIlI .....,,~~Ul
- - IT' CIUI'-._YDRIC II1'AI'Ii......-....
State or ~...~I;..&-7 or-:sc.nnt:h:N ".:
On Dc.:lobeIC. 2.<1,2.00'-1- before me. the lIIIdeni.-I.
pe.-.lly _ored RANDALL C. KELLER
,
penianally _ to me or pnmod .. me ... the IlIIiI ..r _
f-=tory _idODCe to be _ indiviclul(l) _ 1IOIIIe(1) is (_I
__ to _ wIthift iDIlnI_1 ond _...... III .,
!bat bcI_1bcy eMCUIed dle..... in ._....... ...-llJ(iell,
- - by hillhel'ltheir 1i1llUlllWl1) 00 the ~ the iDdi.
vidwoJ(l). or die _ _ -.f 01_ doe 1adlv1dlllol(1)
-. _the __ _ _ _ illdividu.ol_
- __ ~ dIe"-",, in ~'ion,
~""".~ CAroU""O".
(...., dIy rw""'" ....r.-. __... _~",.....",........
_-.,_v,........ ....... .
~M..-t<...'Irot'P....-+ ~'l.I-H..wl"~
f"~~~~""'''''''.' . ~ ~J
I"':) \j)1l9~ "'-Ia.=>.
-..m allll 6ae .,...
Wnw: CowuAll'l' AcM..... c........... .Acn
nn..: No.
BRUCE V. 'KELLER, RANDALL C. KELLER AND
VALERIE C. STEWART, .TRUSTEE~.Df'THE'RUBY
.C. KELLER 1993 QUALIFIED PERSONAL
RESIOENCE TRUST. TO
BRUCE V. KELLER, RANDALL C" ~ELLER
AND VALERIE C. STEWART, AS TENANTS-1N
COMMON
. :,. :.~a.;.'~ ..'.J.. I '.. ..
....... .:. ~ .,...... ,. : ..-
AauJQMfI--
Slale or
COUDly or
If BY .~"_" 011_ wn--....
I...:
On
penonaIly oppcaom
die -biDa wllMll(os) to doe fon:lDiIII insuun-.t, willi
-- I - ,.....uy ___. who, bcIai by me duly
lwam. did ~ and say !bat bcIl11e11hey 1'IIide(1) in 1/1_
",." ""....... 41 ill . ~ .... .. .,..., .." ..., .........
If_"'-'lft.
before me. the undenipal.
!bat bellIIeIIhey know(l)
to be the indiYiduaI(l) __ in and wboeorccuredlbe fen-
aoi... inmumelll; _said _lIiq wilMll(eo) WII (_)
_1_ laW said
execu.. the some: and !bat said willlOSl(oo) 01 IIle ..... time
...- ...-lbeir 1UIIIll(o) II " willlal(eo) ..........
(DU....__N#W...............dO.~ I.---~-'-"..,__
..~",....,.,.. . t .;;.. ADd tbat....1UbIcriIriDa
~oo) _ ~ bet..... _ ...-iped iD
.. ..
.- ..
..- ...~
aJ..A..! ..,.,........ ...... -' A . t. 1
iiiJllll(: .-..~ . a
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\'9\. "UBL\t. /~I
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,%;.;.C~~~~
01 S~IIIU"U~9
SECJ'ION 128
BLOCIt 6
LOT ,..... ..21. :...
OOUNTYoa_ SUFFOLK
.2826 PECONIC BAY BLVD.
LAUREL, NEW YORK
M:&'ru_ BY MAD. TO,
SHLOM: & LITTMAN
37~ LEXINGTON AVENUE
NEW YORK, 'NEW YORK
ZlpNo. 10017
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EXHIBIT A
WITNESSETH, that the party of the first part, in consideration of Ten Dollars and other
valuable consideration 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 at Laurel, Town of Southold, County of Suffolk
and State of New York, bounded and described as follows:
BEGINNING at a point which marks the Northwesterly comer of the premises about to
be described which point is distant South 25 degrees 02 minutes 50 seconds East
191.49 feet when measured along the division line between land now or formerly of G.
Harvey Moore and Robert R. Leslie and land now or formerly of J. Cardinale from a
point where said division line is intersected by the Southeasterly side of Peconic Bay
Boulevard and from said point of beginning running thence North 63 degrees 46
minutes East 91.99 feet to the center line of a right-of-way; running thence along the
same South 23 degrees 58 minutes 30 seconds East 250.93 feet to Great Peconic Bay;
running thence along Great Peconic Bay South 33 degrees 08 minutes 50 seconds
West 102.70 feet to said land now or formerly of J. Cardinale; running thence along said
land North 25 degrees 02 minutes, 50 seconds West 303.11 feet to the point or place of
beginning.
TOGETHER with and subject to a right-of-way to be used by G. Harvey Moore and
Robert R. Leslie and/or their heirs and assigns and by the party of the second part, his
heirs and assigns, for vehicles and other lawful uses; over the following described right-
of -way;
BEGINNING at a point on the Southeasterly side of Peconic Bay Boulevard distant
North 48 degrees 46 minutes 50 seconds East 92.15 feet when measured along the
Southeasterly side of Peconic Bay Boulevard from a point where the easterly side of
land now or formerly of J. Cardinale intersects the Southeasterly side of Peconic Bay
Boulevard and from said point of beginning running thence along the Southeasterly side
of Peconic Bay Boulevard North 46 degrees 46 minutes 50 seconds East 15.70 feet;
running thence South 23 degrees 58 minutes 30 seconds East 260.11 feet; running
thence South 66 degrees 01 minutes 30 seconds West 5 feet; running thence South 23
degrees 58 minutes 30 seconds East 190.93 feet; running thence South 33 degrees 06
minutes 50 seconds West 5.96 feet; running thence North 23 degrees 58 minutes 30
seconds West 192.55 feet; running thence South 66 degrees 01 minutes 30 seconds
West 5 feet; running thence North 23 degrees 58 minutes 30 seconds West 254.85 feet
to the Southeasterly side of Peconic Bay Boulevard at the point or place of beginning.
SUBJECT to the use by G. Harvey Moore and Robert R. Leslie, and/or their heirs and
assigns of the foreshore area at the Southeasterly comer of the premises first above
described as follows:
. .
";'.
BEGINNING at the Southeasterly comer of the premises first above described running
thence along the Great Peconic Bay South 33 degrees 08 minutes 50 seconds West
22.5 feet; running thence North 23 degrees 58 minutes 30 seconds West 20 feet;
running thence North 33 degrees 08 minutes 50 seconds East 22.5 feet; running thence
South 23 degrees 58 minutes 30 seconds East 20 feet to the point or place of
beginning.
SUBJECT to restrictions contained in deed dated July 10, 1970 and recorded in the
Office of the Clerk of the County of Suffolk on July 15,1970 in Liber6774, page 2n.
BEING AND INTENDED TO BE the same premises conveyed to the party of the first
part, by deed dated July 10, 1970 and recorded in the Office of the Clerk of the County
of Suffolk on July 15, 1970 in Liber Sn4, at page 2n.
BEING AND INTENDED TO BE the same premises conveyed to the party of the first
part, by deed dated December 24, 1993 and recorded in the Office of the Clerk of the
County of Suffolk on August 17, 1994 in Liber 11690, at page 092.
TOGETHER with all right, tiUe and interest, if any of the part of the first part in and to
any streets and roads abutting the above described premises to the center Jines 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 or 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 reads "parties",
,"
Number of P"lle5 ({;,
TORRENS
Scriol#
CcJtificalC It
Prior Ctf. #
Deed . M.ortg&ge [nstnllnenl
Deed / MOI'I&_ Thx SlOmp
FEES
3
Pug< / Filing Fee
Hundling
'; JIlL
TP-S84
NOl:.ation
EA.S217 (Counly)
EA.S217 (S'.,c)
R.P.T,S.A.
Sub 1'0101 .
30-
Camm. of Ed.
S JIlL
Aflidavit
Ccrlilicd Copy
R.g. Copy
Sub Totol
Other
Ij8. -
Grand ToU.1
4
1000 12800 0600 021000
Scclion4e.
Block au.. Q/O 1.0' a,I. ()CJO 5
Real
Properly
Tax Service
Agency
VerificAtion :
6
SatisfaclionIDischargeslRelease List Propeny Owners ~:1i1illg Address
~~~~~
RECOP.DED
2004 De<: 22 03:01.43 PH
Edward P.Romaine
CLEllI< OF
SUFFOLK Cl)JNTV
L 000012361
P 852
DT' 04-21241
Recording/ Filinll SlOmps
\ Mo.....g. Aw.
I. Basic Thx
2. Addilional Tux
Sub TOlal
Spec./ Assi!.
or
Spec./ Add.
TOT. MTG TAX
Dual Town _ Dunl Counl)' __
Held for Appoi~mem _
"ram;rcr lax ~
~:msion Tax
The ProlXny cov~n:cJ b)' Ihi.!; mOI&al;.C: i$.
or wiJI be improved by a one or two
fnmily dwc:lling only.
YES or NO
J f NO. see approprialc lax clause 011
page # ot this i m.trument.
<f
Communih' Pre~n'ulion Fund
COlUlideralion Amount S
CI'F Tax Du. 5
Impn)\'cd X
Vacant l..and
TO
I()
TD
TD
7 nUe Com any InCormatlon
Co. Name FIDELlTV NATIONAl. TITJ.E
Till. # -8
8 Suffolk County Recordin & Endorsement Pa e
This page forms part or rhc DLUlChed nmdc by:
~~e.~. "'f>\\~~. ~~"\\ ('. Thc;:::::~:::~::~nRUMENT)
~ ~ ~~\,~ t'lB SUFFOLK COUNTY. NEW YORK. \
TO~~-- E:> In IhcTowlUlhip of ~~o
~'L'F \I ~e.~1 ~'\\. ~. InlhcVILLAGE
~\\~ \ \It).\~ e. ~~ ~ ~\- or H,\MLET of
BOXES .. THROUGH 8 MUST DE TYPED OR PRINTED IN Bl.ACK INK ONLY PRIOR TO RECORDING OR ..lUNG
(ovcr)
111111111111111 11111 1111 1I11111H 1111111111111
111111111111111111111111
SUFFOLK COUNTY CLBRK
RECORDS OFFICI
RBCORDING PAGB
Type of Instrument I DBBDS/mm
Number of Pagesl 6
Receipt NUmber I 04-0139221
TRANSFER TAX NOMBBR: 04-21241
Recorded:
At:
12/22/2004
03 I 01: 43 PM:
LIBER:
PAGB:
D00012361
852
District: Section: Block I Loti
1000 128.00 06.00 021.000
lZYa.JIIlIBD AND CHARGID AS fOLLOWS
Deed Amount: $0.00
Received the Following Fees For Above IDstrument
:z.....""lpt lZY""lpt
Page/Filing' $18.00 NO HaMling $5.00 NO
COE $5.00 NO NYS SRCHG $15.00 NO
EA~CTY $5.00 NO EA-STATB $75.00 NO
TP-584 $5.00 NO Cert.Copies $0.00 NO
RPT $30.00 NO SCTM $0.00 NO
TrlUlsfer tax $0.00 NO COIIIIII.Pre. $0.00 NO
Fees Paid $158.00
TRANSFER TAX HCMBBR: 04-21241
THIS PAGE IS A PART 01' TBB INSTRtJJIEN'1'
THIS IS HOT A BILL
Edward P.Romaine
County Clerk, Suffolk County
FOR COUNTY USE ONLY
I"'LI:;A::;il::. I V....I:; UK r'KI::::iS ~IRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http://www.orps.state.ny.us or PHONE (518) 473-7222
,
IL/7::?'8,f(,9
REAL PROPERTY TRANSFER REPORT
C1. SWIS Code
I
CZ. Date Deed Recorded I J Z / ~2/04 I
. Month y Vur
03. Book I 1.2 3,( {).I I 04. P... ,'2;R 7~
PROPERTY INFORMATION
..
", ..
. .
" J,
..
~
STA.TE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
R\"-:S217K~:tJ97
1. r~::i: I
2826
I
11 9 48 I
llPCOOE
PECONIC BAY BOULEVARO
STFtEETNUM8<.1l
5TREETNAME
L2Ql)THOLO
CITV OR TOWN
LAUREL
VILlAGE
2. Buyer
Name
KELLER
KE tAtERMPANY
<;'TFWART
lASTWlME:/COMPANY
BRUCE
'Il'~ 1tffA L L
VAl FRIE
l'IIISTNAAIE
3. Tax Indicate whE,re future Tax BiUs are to be sent
Billing ifothertl1anbuyeraddresslatbottomoffOfmll
AddTen
~30I CYNTHIA COURT
S1llEET ,~UMaER AHO STREET NAME
KElLER
BRUCE
LAS1'NAME/OOIl-tPANY
FlflSTNAME
PRI NCETON
I N J
STAn::
108540
llPCOOE
CI1"YOIITOWN
# of Parcels OR 0 Part of a Parcet
IOnly If Part of . Parcell Cneek alii they apply:
4A. Planning Board with Subdivision Authority Exists 0
4B. Subdivision Approval was Requirad for Transfer D
4C. Parcel Approved for Subdivision with Map Provided D
4. Indicate the number of Assessment L
Roll parcels transferred on the de.-d
5. Deed
"'.....,
Size
L----.J X L_.
F~O~IT FEEf OI;PTH
lOR I
.
ACRES
6. Selle,-
N.me
I BRUCE V. KELLER , RANDALL C. KELLER &
lAST~"''''E'COMPANV VALERIE STEWART
L--
LAST NAME/COMPANY
fiRST NAME
[TRUSTEES OF RUBY C. KELLER 1993 QUALIFIEQ
FllI8TNAM~ PERSONAL RE::ilUf:.NCE IRUST
7 Check the box below which mQ!St al;:curately describes the UN of the property at the time of ..Ie:
Check the box_ below as they .pp./y:
8. OWr'lership TVpe is Condominium
9. New Construction on Vacant lano
lOA. Property Located within an Agricultural District
lOB. Buyerreceillfld adlsclosur& notice indic8ting
that the property is in an Agricultural Oistril;:t
o
o
o
o
A~oneFamiiYR.Sjde"l;al
B 20r3Famllyflesidllntial
C RllSldltntial Va(;ant Land
D Non-ResldllntiaIVar.ant Land
I SALE INFORMATION I
11. Sale Contrect Date
E~ Agricultural I ~ Community Sllrv;Cll
F Commercia! J lndultrial
G Apllrtment K Public Sllrvice
H Entenainment I Amu6ement L Forest
15. Check one or more of these GOnditlon. _ .pplicllble to tnm$fer:
LMOnth Day ~J
I~ I J?.Cf I OL~
Monlh Day Yllaf
A
B
C
D
E
F
G
H
I
J
CONVEYANCE
RESIOENCE
Sale Between RehJtives or Former Rellrtives
Saie Betwuel1 Relat.d Companies or Partners in Business
One of the Buyers is also i!I Seller
Buyer or Seller is Government Agency or landing Institution
Deed Type not Warranty or Blrgain and Sale (Specify Below)
Sale of Fractional or Less than Fee Interest (Specify Below)
SigniflCllnt Change In Properly Between Taxable Stltus and Sale Dates
S81e of 81lsirtells is Included In Sate Price
Other Unusual Factors Affecting Sala Price (Specify Balow)
None
12. Date of Sale I Transf&/"
13. Full SalePflce , ,O,o,or
, , .
(Full Sale Price is the total amount paid for the property including personal property.
This payment may be in the form 01 cash, other property or goods, or the as.sumptlon of
mortgages or other obi gations.) Please round 10 the fl6Breft whol8 dollar amtwnt.
FROM OUAI 1 FIEO
TRUST
PERSONAL
14. Indicate the wlue of penonal
property h1Clllded in the Site
. 0 , II , II ,
.
ASSESSMENT INFORMATION ~ Data should reflect the latest Final Assessment Roll and Tax Bill
16_ Year of Aa&!il5ment Roll from I 0 '7 1
which information taken
LE.. , .Ol-U
17. Tot~1l AaHned ValulI(of allpMcels in .......'e,-l I
1/ iJoo,
19. School Dmttic:t Name L
\ C"'~\
_.. .
,
'jY'i~~
C,Jc. fIG~
la, Property Cl.li$
20. Tax Map Identmer{s} I Roll Identffjerl$J !If more u..n four, 8ttec:h sheet with additionllldentifieris))
~ISL
/000 SECT. 128 BLOCK 6 LO..'!j211
--.J
.....J
I CERTIFICATION
I certU:" that all of.he items of Wf"orrnation entered on t1tls fonn are.Ini(l1lnd coJTect (to the best of my knowledge and belief) and I undeTSland that the makhl:
of an~ "illfol raise ~tatell1ent uf material fad herein will subject me to the provisiom of the oenaI law relative to the making and RUng of false instromenls.
~ BUYER'S ATTORNEY
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301 ~ CYNTHIA COURT
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LITTMAN THOMAS
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I.ASTN"-ME FIRST NA"'~
212 532-6682
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SELLER
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NEW YORK STATE
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