HomeMy WebLinkAboutL 12187 P 373INSTRUCTIONS: ,l~tp:/~,wvvw.orps.state.ny. us or PHONE (518) 473-7222
Month Day Year
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK '~'
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP-5217 Rev 3/97
Location --
ST~ET NUMBER
Indicate where future Tax Bill~ are to be,sept
if other than buyer address (it bottom of Tf~rm)
'- ' ~ST"~'C6MPANY
3. Tax
Billing
Address
STREET NUMBER AND STREET NAME
4. Indicate the-~i~mber'of--" Assessment
Roll parcelS transferred on the deed
Ixl
VILLAGE
5. Deed,
Size ,~m~,.~*-''~FRONT FEET
'~?~' I Sorgen
· 6. Seller
Philip ~ ~
FI,R ST NAME
CarOl%
FIRST NAME
~" '"' :' ~ FIRST NAM~'E
1
ZIP CODE
I
CITY OR TOWN
I , I I
STATE ZIP CODE
. , II #of Parcels OR E~ PartofaParcel
IoRl ", , o , I
(Only if Part of a Parcel) Check as they apply:
4A. Planning Board with Subdivision Authority Exists []
4B. Subdivision Approval was Required for Transfer []
4C. Parcel Approved for Subdivision with Map Provided []
] Philio
Name LAST NAME COMPANY FIRST NAME
I Sorgen I Carole
LAST NAME ! COMPANY FIRST NAME
7. Check the box below which most accurately describes the use of the property at the time of sale:
2 or 3 Family Residential
Residential Vacant Land
Non-Residential Vacant Land
I I
11. Sale Contract Date
12, Date of Sale ! Transfer
Commercial Industrial
Apartment Public Service
Entertainment ! Amusement Forest
"' /: fi, .'
Month ~)ay '~ t~Year
Month Day Year
13. Full Sale Price { ~ ~ ~ ~ , , , , 0 I 0 , 0 I
¢~,, ~ ~ ·
(Full Sale Price is the total amount paid for~the property including personal property.
This payment may be in the form of cash, Other 15rdp~rty or goods, or the assumption of
mortgages or other obligations.) Please roun'd to the nearest whole dollar amount.
Check the boxes below as they apply:
8. Ownership Type is Condominium []
9. New Construction on Vacant Land []
IOA. Property Located within an Agricultural D~strict []
10B. Buyer received a disclosure notice indicating []
that the property is in an Agricultural District
15. Check one or more of these conditions as applicable to transfer:
A Sa~ Between Relatives,,~r Former Relatives
"B Sale Between Related C~mpanies or Partners in Business
c
D
F
G
H
I
or Seller is Government Agency or Lending Institution
Deed Type not Warranty or Bargain and Sale (Specify Below)
Sale of Fractional or Less than Fee Interest (Specify Below)
Significant Change in' Property Between Taxable Status and Sale Dates
Sale of Business is inclu~ed in Sale Price
Other Unusual Factors Affecting Sale Price (Specify Below)
No~;.~
49 J Hi9htop Lane
STREET NUMBER STREET NAME (AFTER SALE)
Jericho
CITY OR TOWN
~ ; ~ SELLER
SELLER SIGNA~TLIRE
N.Y. 11753
I I
STATE ZIP CODE
Sam~Rut
LAST NAME
AREA CODE
i Norman.
FIRST N/~ME
739-i735
I
TELEPHONE NUMBER
16. Year of Assessment Roll from
*%~_~_ic_h information taken I~'[ J 17. Total Assessed Value (of all parcels in transfer) I , ,
1~8. P ~ L, I-I I 19. School District Name I ~' < I
2~.T~xMap~dent~r{~/R~d~ntifier~s~(ifm~rethanf~u~at~achsheetwithaddit~na~identi~r~s)) I- q0
/
I certify t~'a]l of the items of information entered on this form are d correct (to tile best ~-m~ kno~le~se a~d belied and l~demtand tl~t the makJn~
of any willful false statement of material tact herein will subject me to the provmions of the pemd la~ r~ative ~ thc .re. akin8 and filing of false instruments.
14. Indicate the value of personal
property included in the sale