HomeMy WebLinkAboutL 12863 P 871 11111111111111111111111111111111H111111111111111111111
1111111011111
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: MISCELLANEOUS - DEED Recorded: 05/10/2016
Number of Pages: 3 At: 10: 13:40 AM
Receipt Number : 16-0072416
LIBER: D00012863
PAGE: 871
District: Section: Block: Lot:
0800 051 .00 07 .00 005 . 004
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 $0.00
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
•
JUDITH A. PASCALE
County Clerk, Suffolk County
on
RECORDED
Number of pages 3 2016 Rag 10 10:13:40 PM
JIJDITH R. PRSCRLE
CLERK OF
This document will be public SU LF00 COUNTY
L 00COUNTY
record. Please remove all P 871
Social Security Numbers
prior to recording.
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 FEES
Page/Filing Fee Mortgage Amt.
1. Basic Tax
Handling 20. 00
2. Additional Tax
TP-584 Sub Total
Notation Spec./Assit.
or
EA-52 17(County) Sub Total Spec./Add.
EA-5217(State) TOT.MTG.TAX
Dual Town Dual County
R.P.T.S.A.
Held for Appointment
Comm.of Ed. 5. 00 1 t Transfer Tax
Mansion Tax
Affidavit
The property covered by this mortgage is
Certified Copy or will be improved by a one or two
NYS Surcharge 15. 00 family dwelling only.
Sub Total YES or NO
Other
Grand Total f2,X,Off+ If NO,see appropriate tax clause on
_ page# of this instrument.
4 Dist. Section Block Lot l�l 5 Community Preservation Fund
Real Property Consideration Amount$
Tax Service
Agency CPF Tax Due $
Verification
Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
/ �RRECORD&RETURN TO: Vacant Land
—D. /(�/l .qr/LZj�iyLQGG2— TD
PI S'A I TD
3°0 Coit,*r• Dr. a F I. TD
f(RDI
Mail to:Judith A. Pascale, Su-folk County Clerk 7 Title Company Information
310 Center Drive, Riverhead, NY 11901 Co Name
www.suffolkcountyny.gov/clerk Title#
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached AFFIDAVIT OF CORRECTION ni;; made by:
(SPECIFY TYPE OF INSTRUMENT)
The premises herein is situated in 1
SUFFOLK COUNTY,NEW YORK. J.--.5J.--.5!['e
TO In the TOWN of StA�� T-0/37(11/
In the VILLAGE l /�n
or HAMLET of ealY16i y�``/ /61/14P PTO
BOXES 6 THRU 8 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 Identifiers) listed on the reverse.
Gary M. Simonson Yvt_ '14-t—vv"1"-t:-
Deputy Director
UNIFORM FORM CERTIFICATE OF ACKNOWLEDGEMENT
STATE OF NEW YORK )
)§:
COUNTY OF SUFFOLK )
On the /� day of /774-7 in the year -266 , the undersigned,
personally appeared ��}-�Z.- 1, V%n?or--)J 0r,c personally known to me or
r
proved to me on the basis of satisfactory evidence to be the individual(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.
4 --
Notary Public
BRUCE M.HOTCHIQSS
Notary Public,State of New York
No.01E106108793
Qualified in Suffolk County
Commission Expires 04!19120 °i2�