HomeMy WebLinkAboutL 12851 P 957 mmmmmmmmmmummmmmmiemmm
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SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: AGREEMENT Recorded: 02/09/2016
Number of Pages: 2 At: • 12 :58 :13 PM
Receipt Number : 16-0019387
LIBER: D00012851
PAGE : 957
District: Section: Block: Lot:
1000 078.00 08 . 00 002 . 000
EXAMINED AND CHARGED AS FOLLOWS
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $10 . 00 NO Handling $20 . 00 NO
COE $5 . 00 NO NYS SRCHG $15 . 00 NO
Affidavit $0 . 00 NO TP-584 $0 . 00 NO
Notation $0 . 00 NO Cert.Copies $0 .00 NO
RPT $200 . 00 NO
Fees Paid $250 .00
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
Number of pages , RECORDED
2016 Feb 09 12:58:13 PM
JUDITH A. PASCALE
CLERK OF
This document will be public SUFFOLK COUNTY
record. Please remove all L 000012851
Social Security Numbers P 957
prior to recording.
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 FEES
Page/Filing Fee 16 ! @Mortgage Amt.
1. Basic Tax
Handling 20. 00
—
2, Additional Tax
TP-584 Sub Total _
`otat of n I SpecJAssit.
r6(3or
EA-52 17(County) Sub Total Spec./Add. _
EA-5217(State) TOT.MTG.TAX
hl11/ um, ,`' Dual Town Dual Count
R.P.T.S.A. --��►►��44,,LL '�',, Y—
' Held for Appointment
Comm.of Ed. 5. 00 '`�
i'' ,' p„ Transfer Tax
1�iii, +:r, - —
Affidavit ,J Mansion Tax _
The property covered by this mortgage is
Certified Copy or will be improved by a one or two
NYS Surcharge 15. 00 '0-10_-- family dwelling only.
Sub Total YES or NO
Other
Grand Total � If NO,see appropriate tax clause on
Oi :.ge# of this instrument.
I OO U 3095006 1000 07800 0800 002000
K'
4 Dist. 5 Community Preservation Fund
P T 1111111111111111111111IIUI 11111 IIIII11111111
Real Property R SMI A I IN 11111 p11I1111111111I�III1111111111111 Consideration Amount $
Tax Service 05-FEB-16
Agency CPF Tax Due $
Verification - - --- - - — - - -
Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD
S
RD&RETURN TO: Vacant Land
N4V 1C41� t'4-13-1--(-4 TD
PO Q-0-?4 CIS TO
WaCtian -,`\112-i)I 92-0\-( inTD
Mail to: Judith A. Pascale, Suffolk County Clerk 7 TitleT� `` Company Information
310 Center Drive, Riverhead, NY 11901 Co.Name H-A,J 8 c krs1-rgc‘r-
www.suffolkcountyny.gov/clerk
Title# R: 5
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached 1J' ° P made by:
( (SPECIFY TYPE OF INSTRUMENT) JJJJ
S C *De to"+ O- E?C\c 1 CCS r\) The premises herein is situated in
SUFFOLK COUNTY,NEW YORK. 1
(t TO �((�� In the TOWN of 0 k 1
ES -4.k-' Ze- iSQ-L r q 1'r.1,v..0 c In the VILLAGE '1
or HAMLET ofs. DV 018--
BOXES•6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
12.0104..10108kk
(over)
STATE OF NEW YORK) Estate of Barbara Primich
ss: Case#: P00 G00396
COUNTY OF SUFFOLK)
RELEASE OF AFFIDAVIT OF ESTATE CLAIM AGAINST PROPERTY
Release is hereby given of AFFIDAVIT OF ESTATE CLAIM dated March 6, 2012,
by the Suffolk County Department of Social Services at 3085 Veterans Memorial
Highway, Ronkonkoma, New York, against the Estate of Barbara Primich recorded
in the Suffolk County Clerk's Office on March 30,2012 in Liber 12689 Page 344.
This Release is given due to ( ) withdrawal or(X ) satisfaction of our claim.
KENNETH APPS, hief Management Analyst
of Suffolk County Department of Social Services
STATE OF NEW YORK)
ss:
COUNTY OF SUFFOLK)
On the VA= day of January in the year two thousand and sixteen before me, the
undersigned personally appeared Kenneth Knappe, personally known to me or proved to
me on the basis of satisfactory evidence to be the individual whose name is subscribed to
the within instrument and acknowledged to me that he executed the same in his capacity,
and that by her signature on the instrument, the individual, or the person upon behalf of
which the individual acted, executed the instrument.
0
_... larst4\K• OnalnA,
Nry Public
'O
N yRAnders
Notary Public.State of New Yililt
`No. [l l M461118585
Qualified in Suffolk County
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