12

Numberofpages

Thisdocumentwillbepublic

record.PleaseremoveallSocialSecurityNumberspriortorecording.

Deed/MortgageInstrumentDeed/MortgageTaxStampRecording/FilingStamps

3FEES

MortgageAmt.

EA-5217(State)

SubTotal

1.BasicTax

2. Additional Tax

SubTotal

Spec./Assit.

or

Spec./Add.TOT.MTG.TAX

DualTown DualCounty HeldforAppointment

TransferTax

MansionTax

Thepropertycoveredbythismortgageis

SubTotal GrandTotal

or will be improved by aone orfamilydwellingonly.

YES orNO

IfNO,seeappropriatetaxclauseonpage# ofthisinstrument.

two

4Dist.SectionBlockLot5 CommunityPreservationFund

RealProperty

TaxServiceAgencyVerification

6Satisfactions/Discharges/ReleasesListPropertyOwnersMailingAddress

RECORDRETURNTO:

ConsiderationAmount$ CPFTaxDue$ Improved

VacantLand

TD

TD

TD

Mailto:JudithA.Pascale,SuffolkCounty Clerk

310CenterDrive,Riverhead,NY11901

7TitleCompanyInformation

Co.Name

Title#

8SuffolkCountyRecordingEndorsementPage

Thispageformspartoftheattached madeby: (SPECIFYTYPEOFINSTRUMENT)

Thepremiseshereinissituatedin

SUFFOLKCOUNTY,NEWYORK.

TOIntheTOWNof

IntheVILLAGE

orHAMLETof

BOXES6THRU8MUSTBETYPEDORPRINTEDINBLACKINKONLYPRIORTORECORDINGORFILING.

(over)

IMPORTANTNOTICE

Ifthedocumentyou'vejustrecordedisyourSATISFACTIONOFMORTGAGE,pleasebeawareofthefollowing:

Ifaportionofyourmonthlymortgagepaymentincludedyourpropertytaxes,*youwillnowneedtocontactyourlocalTownTaxReceiver sothatyoumaybebilleddirectlyforallfuturepropertytaxstatements.

Localproperty taxesare payabletwice a year:on or before January10th and on or before May 31st.Failuretomakepaymentsinatimelyfashioncouldresultinapenalty.

PleasecontactyourlocalTownTaxpayment. / Receiver / withanyquestionsregardingproperty / tax
BabylonTownReceiverofTaxes
200EastSunriseHighway / RiverheadTownReceiverofTaxes
200HowellAvenue
NorthLindenhurst, N.Y.11757
(631)957-3004 / Riverhead,N.Y.11901
(631)727-3200
BrookhavenTownReceiverofTaxes
OneIndependenceHillFarmingville,N.Y.11738(631)451-9009 / ShelterIslandTownReceiverofTaxes
ShelterIslandTownHallShelterIsland,N.Y.11964(631)749-3338
EastHamptonTownReceiverofTaxes
300PantigoPlace / SmithtownTownReceiverofTaxes
99WestMainStreet
EastHampton,N.Y.11937
(631)324-2770 / Smithtown,N.Y.11787
(631)360-7610
HuntingtonTownReceiverofTaxes / SouthamptonTownReceiverofTaxes
100MainStreet / 116HamptonRoad
Huntington,N.Y.11743
(631)351-3217 / Southampton, N.Y.11968
(631)283-6514
IslipTownReceiverofTaxes
40NassauAvenueIslip,N.Y.11751(631)224-5580 / SoutholdTownReceiverofTaxes
53095MainStreetSouthold,N.Y.11971(631)765-1803

Sincerely,

dw

2/99

JudithA.Pascale

SuffolkCountyClerk

12-0104..06/06kd