HomeMy WebLinkAboutL 12205 P 526
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INSTRUCTIONS: http://www.orps.state.ny.us or PHONE (518) 473-7222
FOI~COUNTY USE ONLY
C1. SWIS Code
C2. Date Deed Recorded I ,:~ / 2,' ~,, / ~ I
Month Day Year
C3. Book I //~ ,~, ~'~', ~'-'[C4. Page I ,
PROPERTY INFORMATION I
1.LocationPr°perty I
STREET NUMBER STREET NAME
CITY OR TOWN
B. suy., I
Name L~ST NAME / COMPANY
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP- 5217
I I I
LAST NAME [ COMPANY FIRST NAME
3. Tax Indicate where future Tax Rills are to be sent
Billing if other than buyer address (at bottom of form)I r
4. Indicate the number of Assessment I
Roll parcels transferred on the deed ~ , · ~ # of Parcels OR Part of a Parcel
Propert~ [ I xl- JoBI , , , · , I
s. sel,er
I LAST NAME / COMPANY I Fi~ST NAME
7. Check t? box below which most a~urately describes the use of the property at the time of
Al.~ One Family Residential E [] Agricultural [ [] Community Servic~
~ ~ 2 or 3 Family Residential F ~ Commercial J ~ Industrial
C ~ Residential Vacant Land ~ ~ Apa~ment ~ Public Se~ice
D~ Non-Residebda~ Vacant Land ~ Ente~ainment/Amusement ~ Forest
I sa~ INFORMA~ON I . ~
(Onlg R Part of a Parcel) Chedx as ti~ey apply:
4A. Planning Board with Subdivision Authority Exists []
4B, Subdivision Approval was Required for Transfer []
4C. Parcel Approved for Subdivision with Map Provided []
Check the bexe~ below as they apply:
8. Ownership Type is Condominium []
9. New Construction on Vacant Land []
10A. Property Located within an Agricultural District []
1Off Buyer received a disclosure notice indicating []
thst the pro[:~/is in an Agricultural District
15. Chsck one or more of ~ condffeons as apphcable to transfer.
A Sale Bet~veen Relatives or Former Relatives
Month Day Year
12. Date of Sale / Transfer
Month Day Year
13. Full Sale PriceI , , , , , , , , ~ 0 , 0 I
(Full Sale Price is the total ~mount paid for the property inctuding personal property.
This payment may be in the form of cash, other property or goods, or the assumption of
mortgages or other obllgations.) Please round to the nearest whole do#ar amount.
B Sale Between Related Companies or Partners ir~ Business
C One of the Buyers is also a ~Seller
D Buyer or Seller is Govermnent Agency or Lending Institution
E Deed Type not Warranty or Bargain and Sale {Specify Below)
F Sale of Fractional or Less than Fee Interest (Specify Below)
Significant Change in Property Between Taxable Statues and Sale Dates
Sale of Business is Included in Sale Price
I Unusual Factors Affecting Sale Price (Specify E~elow)
J 'None
I CERTt~TION I
BUYER
BUYER SIGNATURE DA
STREET NUMBER S~E~ NAM~ (~R SALE)
BUYER'S ATTORNEY
EIRST NAME
Z -- o Zoo
AREA CODE
TELEPHONE NUMBER
ICITY/TOWN ASSESSOR
COpY
16. Year of Assessment RoB from I , 117. Total Assessed Velue lof ell parcels in transfer) l
which ioformatien taken ~. ~/~'
18. Property Class ' Z, [ ~-' ' 19. School District Name ' ~(~ ~
20. Tax Map Ident.®rls)/Roll ,deotiflerls)(If more than four. attach sh®at with additionel ideotifierls)l ~*~ -- q-- 37
' /e, Oo , , oW-:. on
t,l. Indicate tbevelueofpersonal I ...... L~, 0 0 I
I ASSES~ENT INFORMA~ON - O~a should mfl~ the late~ Fi~l Assessment Roll and Tax Bill