HomeMy WebLinkAboutL 12854 P 908SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: MISCELLANEOUS - DEED
Recorded: 03/03/2016
Number of Pages:
3
At:
12:52:11 PM
Receipt Number :
16-0032570
LIBER:
D00012854
PAGE:
908
District:
Section:
Block:
Lot:
0208
018.00
06.00
031.000
EXAMINED
AND CHARGED AS FOLLOWS
Received the Following Fees For
Above Instrument
Exempt
Exempt
Page/Filing
$0.00
YES Handling
$0.00 YES
COE
$0.00
YES NYS SRCHG
$0.00 YES
EA-CTY
$0.00
YES EA -STATE
$0.00 YES
TP -584
$0.00
YES Notation
$0.00 YES
Cert.Copies
$0.00
YES RPT
$0.00 YES
Fees Paid
$0.00
THIS PAGE IS
A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
* . A
Number of pages 3,
This document will be public
record. Please remove all
Social Security Numbers
prior to recording.
RECORDED
2016 Isar 03 12:52:11 PM
JUDITH R. PASCALE
CLERIC OF
SUFFOLK COUNTY
L D00012854
P 908
Deed / Mortgage Instrument I Deed / Mortgage Tax Stamp I Recording / Filing Stamps
FEES
Page /Filing Fee
Mortgage Amt.
I. Basic Tax
Handling 20. 00
2, Additional Tax —
TP -584
Sub Total
Notation
Spec./Assit.
or
EA -52 17 (County) Sub Total
Spec. /Add. —
EA -5217 (State)
TOT. MTG. TAX —
—
R.P.T.S.A.
Dual Town Dual County—
Comm. of Ed. 5. 00
Held for Appointment
Transfer Tax —
Affidavit — �'
Mansion Tax —
Certified Copy
The property covered by this mortgage is
or will be improved by a one or two
NYS Surcharge 15. 00
family dwelling only.
— Sub Total
YES or NO
Other
_
Grand Total
If NO, see appropriate tax clause on
page # of this instrument.
4
1 Dist.
Section
Block
Lot
5 1
Community Preservation Fuad
Real Property
Consideration Amount $
Tax Service
Agency
CPF Tax Due $
Verification
Improved
6
Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD & RETURN TO:
Vacant Land
[
TD
[�
TD
300/
TD
� �9Q
Mail to: Judith A. Pascale, Suffolk County Clerk
7 Title
Cornvany Information
310 Center Drive, Riverhead, NY 11901
www.suffolkcountyny.gov/clerk
-Co. Name
Title #
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached _ ANNIR �(OR�N r(/(,(Sl ' "�" made by:
jj9ff S RUMENT)
The premises herein is situated in
SUFFOLK COUNTY, NEW YORK.
TO In the TOWN ofrt
In the VILLAGE
or HAMLET of
BOXES 6 THRU S MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING
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AFFIDAVIT TO CORRECT NUMERIC IDENTIFIER
I, the undersigned, Deputy Director of the Real Property Tax Service Agency, Acting for
the Director of the Real Property Tax Service Agency, present this affidavit for the
purpose of correcting the Real Property Tax Map Identifier(s) listed on the reverse.
Gary M. Simonson
Deputy Director
UNIFORM FORM CERTIFICATE OF ACKNOWLEDGEMENT
STATE OF NEw YORK )
COUNTY OF SUFFOLK )
On the V
day of
'20/4
in the year -2W , the undersigned,
personally appeared�'9p"Iy V%°�.c.! �,-�
personally known to me or
proved to me on the basis of satisfactory evidence to be the individua(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their
capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person
upon behalf for which the individual(s) acted, executed the instrument:.
40taryPublic
BRUCE M. HOTCHKISS
NOUq Public, State o1 New York
No. O1HO6108793
Qualified in Suffolk County Q
COM1798sion Expires 04/19)20—
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