HomeMy WebLinkAboutL 12682 P 5SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
T~pe of Instrument: MISCELLANEOUS - DEED
Number of Pages: 3
Receipt Number : 12-0003868
District:
0200
Recorded:
At:
LIBER:
PAGE:
Section: Block:
979.80 01.00
EXAMINED AND CHARGED AS FOLLOWS
Received the Following Fees For Above Instrument
Exempt
Page/Filing $0.00 YES Handling
COE $0.00 YES NYS 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
JUDITH A. PASCALE
County Clerk, Suffolk County
01/11/2012
03:31:11 PM
D00012682
OO5
Lot:
014.000
$0 00
$0 00
$o oo
$0 oo
$o oo
$0 00
Exempt
YES
YES
YES
YES
YES
Number of pages
This document will be public
record. Please remove all
Social Security Numbers
prior to recording.
31
Deed / Mortgage Instrument Deed / Mortgage Tax Stamp
RECORDED
2012 Jan 11 03:31:1t PM
JUDITH A. PASC~LE
CLERK OF
SUFFOLK COUNTY
L D00012682
P 005
.Reco[ding / Filing Stamps
Page / Filing Fee ~
Handling 20. 00
TP-584
Notation'
EA-52 17 (County)
EA-5~7 (State)
Comm. of Ed. 5. 00
Affidavit
Certified Copy
NYS Surcharge 15. 00
Other
Re, Property
Tax Service
Agency
Verification
Section
SubTotal
Sub Total
Grand Total(~~ ~ ...... ~'
IBl°ck 'l t '
Mortgage Amt.
1. Basic Tax
2. Additional Tax
Sub Total
SpecdAssit.
or
Spec./Add~ __
TOT. MTG. TAX
Dual Town ~ Dual County
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, see appropriate tax clause on
page # ~ of this instrument.
5 [Comm-?;ty Preservation
Consideration Amount $
CPF Tax Due $
· ' Improved
Satasfactions/Discharges/Releases List Property Owners Mailing Address
~ ~RECORD & RETURN TO: . Vacant Land
Mail to: Judith A. Pascala, Suffolk Oounty Clerk I 7 I Title Company Information
S10 Center DriYe, gtivorhead, NY llO01 I_ . "
www.$uffolkcountyny, gov/olork l~.oj ~ame ...
I ~lUe ~
Suffolk County Recording & Endorsement Page
(SPECIFY TY~E OF~INSTRUMENT)
The premises herein is situated in
SUFFOLK COUN'IT, NEW YORK.
made by:
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.
(over)
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ff~FFiESAVIT TO COi~._ECT NX_71VI~RIC: XI)IgNTI~-R ~ '
· Director of the Real Prope~ Tax Se~ce Agency,
I, the undersized, Depu~ ._ .__, o .... -~ Tax Se~ce ~ency, pr~ent t~
Acting for the Director ot me ~ ~-~ ~._~,~ ~.~ M~n deufifierts)
affida~t for the purpose ot corr~ung m~ r
listed on the revere.
Gary M.' Simonson
Deputy Director
ur,rn~_o~ Foxttvx C~T~XC~-TE oF ~Ci,~oWLX~ZsG~:~v~-~rr
STATE Or NEW YOS.K )
)§:
C013f1"/OF SUI~OLK ) z~ if//~//
On the~ day ~ "~ the year ~ the ~de~i~ed,
pe~onaHY appeared ~ ~l~o~ o~ , pe~onaHy ~o~ to me
or proved to me on the b~ of sa~facto~ ~dence to be the ~d~duai(s) whose name(s) ~/are
subscribed to the ~t~ ~~ent and ac~owledged to me ~shgth~ executed the same
er/the~ capacitor), and that er/theft s~a~re(s) on the ~s~ent, the
~d~dual(s), or ~e ne~on beh~ for w~ch the ~d~duM(s) acted, ex~uted the
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