1 2 Number of pages This document will be public record. Please remove all Social Security Numbers prior to recording. Deed / Mortgage Instrument Deed / Mortgage Tax Stamp FEES Recording / Filing Stamps 3 Page / Filing Fee ___________ ____ Mortgage Amt. 1. Basic Tax ___________ _____ ___________ _____ Handling TP-584 Notation 20. 00 ___________ ____ ___________ ____ ___________ ____ Sub Total ______________ 2. Additional Tax ___________ _____ Sub Total ___________ _____ Spec./Assit. EA-52 17 (County) ___________ ____ EA-5217 (State) ___________ ____ or Spec. /Add. ___________ _____ TOT. MTG. TAX ___________ _____ Dual Town _____ Dual County ____ Held for Appointment ________ Transfer Tax Mansion Tax ___________ _____ ___________ _____ R.P.T.S.A. Comm. of Ed. Affidavit ___________ ____ 5. 00 ___________ ____ ___________ ____ Certified Copy NYS Surcharge Other ___________ ____ 15. 00 ___________ ____ ___________ ____ Grand Total _______________ Sub Total _______________ 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. 4 Dist. Section Block Lot 5 Community Preservation Fund Consideration Amount $ ___________ CPF Tax Due $ _______________ Improved_________ Real Property Tax Service Agency Verification 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD & RETURN TO: Vacant Land ______ TD _____________ TD _____________ TD _____________ 7 Mail to: Judith A. Pascale, Suffolk County Clerk 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 ________________________________________________________ made (SPECIFY TYPE OF INSTRUMENT) by: _______________________________________________ The premises herein is situated in _______________________________________________ SUFFOLK COUNTY, NEW YORK. TO _______________________________________________ _______________________________________________ In the TOWN of ____________________________________ In the VILLAGE or HAMLET of _____________________________________ (over) American LegalNet, Inc. www.FormsWorkflow.com BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. IMPORTANT NOTICE If the document you've just recorded is your SATISFACTION OF MORTGAGE, please be aware of the following: If a portion of your monthly mortgage payment included your property taxes, *you will now need to contact your local Town Tax Receiver so that you may be billed directly for all future property tax statements. Local property taxes are payable twice a year: on or before January 10th and on or before May 31st. Failure to make payments in a timely fashion could result in a penalty. Please contact payment. your local Town Tax Receiver with any questions regarding property tax Babylon Town Receiver of Taxes 200 East Sunrise Highway North Lindenhurst, N.Y. 11757 Riverhead Town Receiver of Taxes 200 Howell Avenue Riverhead, N.Y. 11901 (631) 957-3004 Brookhaven Town Receiver of Taxes One Independence Hill Farmingville, N.Y. 11738 (631) 451-9009 East Hampton Town Receiver of Taxes 300 Pantigo Place East Hampton, N.Y. 11937 (631) 727-3200 Shelter Island Town Receiver of Taxes Shelter Island Town Hall Shelter Island, N.Y. 11964 (631) 749-3338 Smithtown Town Receiver of Taxes 99 West Main Street Smithtown, N.Y. 11787 (631) 324-2770 Huntington Town Receiver of Taxes 100 Main Street Huntington, N.Y. 11743 (631) 360-7610 Southampton Town Receiver of Taxes 116 Hampton Road Southampton, N.Y. 11968 (631) 351-3217 Islip Town Receiver of Taxes 40 Nassau Avenue Islip, N.Y. 11751 (631) 224-5580 (631) 702-2470 Southold Town Receiver of Taxes 53095 Main Street Southold, N.Y. 11971 (631) 765-1803 Sincerely, Judith A. Pascale Suffolk County Clerk dw 2/99 12-0104.. 06/06kd American LegalNet, Inc. www.FormsWorkflow.com