HomeMy WebLinkAboutL 12658 P 261SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: MISCELLANEOUS - DEED
N,,m~er of Pages: 3
Receipt Number : 11-0047955
District: Section: Block:
0200 961.00 03.00
EXAMINED AND CHARGED AS FOLLOWS
Received the Following Fees For Above Instrument
EXe~l~t
Page/Filing $0.00 YES Handling
COE $0.00 YES N~S SRCHG
EA-CTY $0.00 YES EA-STATE
TP-584 $0.00 YES Notation
Cert. Copies $0.00 YES RPT
Fees Paid
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
Recorded:
At:
LIBER:
PAGE:
Lot:
018. 000
$0.00
$o.oo
$o.oo
$0.00
$0.00
$0.00
04/26/203.1
03:59:46
D00012658
261
YES
YES
YE8
YES
YES
JUDITB A. PASCALE
County Clerk, Suffolk County
This document will be public
record. Please remove ali
Social Security Numbers
prior to r~ording.
Deed I Mpngage Instmrnant
De~d I Mortgage Tax Stamp
FEEg
RECOP-~£D
2011 Apr 26 g~:~:46 Pti
3UDI'I'H fl, PP..SCALE
CLERK OF
SUFFOLK COUNW
L 0000126,~
Reco~ing / Filing Stamps
Page t Filing Fee
Handling 20. O0
Nola6on
EA-52 17 (Co,.nty)
EA-5217 (Stat~
R.P. TS.A. 4~
Comm. of B.d. 5. O0
Affidavit
Certified Copy
NYS Surcharge 15. 00
Sub Total
Sub Tolal
I
4 [ Dist.
Real Propm'ty
Tax Servic~
Age. ney
Verification
Section
Graad Total ~ J
5
Mortgage Amt.
1. Bgsic 'lhx
2. Additional Tax
Sub Total
Spec JAs~it.
or
SImc. lAdd. __
TOT. MTG. TAX
Dual Town __ Dual Coun~
Held for Appointment --~
Transfer Tax
Mansion Tax
The property covered by this mortgage is
or will be improved by a one or two
family dwelling only.
YES~ or NO ~
If NO, ~ approprla~e lax ¢lanse on
page # ~ of this instxungnt.
Communi~ Preservation Fund
Consideration Amount $
CPF Tax Due $
S~isfactions/Disch~._arges/Rel,~ases List Pmpe~ Ow~ M~Hng Ad~ss ~v~ ~
~ ~ ~0~ a ~T~ ~: . V~t ~d
~tO ~~~ ~-~
~ t ~.~.' ~tqol -~
Ma~l to: Judi~h A. pa~al~:' suflol~ ~nty Cl~rk I 7 I ~fle Core.ny ~formafion
a~0 Centsr Ddw, Rivorhsad, NY ~1901 I_ . ' ................
~.su~lk~un~ny. gov/cle~ ,,~.~: ~ama ,
~ , [ [l~g F ..,
S olk County Recording & EndorSement PaRe
(SPEC]FY TY~ OF'INSTRUMENT)
The pr~mis~s herein is situated in
SUFFOLK COUNTY, NEW YORK.
TO In the TOWN of
In the VILLAGE
or HAMLET of
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
I--
W
~Oo ooOO
I, tho undersigned, Deputy Director of tho Real trope.try Tax Service Ag.ea..~.,
Acting for the Director of the ReM. Property Tax 8erwee~Age.n.cy, .p.rese..n.t tn.~.
affidavit for the purpose of correcting the Real Property xax ~zap zaennner~s)
listed on the reverse.
Gary M: $imonson
Deputy Director
.(JNiFO. ii~ ~,0~glvI CF.,RT~.CATE (~)F ACKNQ",V~-~zn. GElVlENT
STAT~ 0~ Nzw Yomc )
)§:
Cot~O~ Sur~otat )
personally appeared ....... ~A~. f44 ,. ~"i~.__c~/,~ o~
in the year ~ the undersigned,
., personally known to me
or p~oved to me on ~e basis of satisfactory evidence to be the individual(s) whose nme(s) is/are
subscribed to the within instrument nnd .acknowledged'to me th~./~she/they ~eeuted the same
~er/thelr capaeity(ies), and that ~her/their signnture(s) on the tnstrmnent, the
individual(s% or the. ne~nn upon behalf for wbieh the indlvidn, al(s) ncted, exetnted the
instrument.
Notary Public