West Orange Township_Fourth Round HEFSP_Final Draft

RIF-1 (Rev. 7/08) MUSTGUBMIT IN DUPLICATE STATE OF NEW JERSEY AFFIDAVIT OF CONSIDERATION FOR USE BY SELLER (Chapter 49, P.L.1988, as amended through Chapter 33, P.L. 2006) (N.J.S.A. 46:15-5 at seq.) BEFORE COMPLETING THIS AFFIDAVIT, PLEASE READ THE INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM. STATE OF NEW JERSEY FOR RECORDER, USE ONLY. hss cipal Code Consideration County Municipal: RIF paid tr : O72 paid by COUNTY BERGEN Date. As Mp OF By MUNICIPALITY OF PROPERTY LocaTion West Orange “Use symbol °C" to indicate thal fee is exclusively for county use. (1) PARTY OR LEGAL REPRESENTATIVE (See instructions #3 and #4 on reverse side) Deponent, _Jattes J. Delia, Esq. being duly swom = according to law upon histher oath, deposes and says hat he/she's ing_L&AL Representative ina qeed dated 10/28/2008 transferring (Grantor, Legal Representative, Corporate Officer, Officer of Tite Company, Lending Institution, etc.) real property idantifiad as Block number 17.14 Lot number 108 located at 161 a/k/a 167 Pleasant Valley Road, Wast Orange and annexed thereto. (Street Address, Town) (2) CONSIDERATION s__0-00 (See Instructions #1 and #5 on reverse side) (@) Property transferred is Class 44 4B 4C (circle one). If property transferred is Class 4A, calcwation i 3A below i$ required. (BA)REQUIRED CALCULATION OF EQUALIZED VALUATION FOR ALL CLASS 4A COMMERCIAL (See Instructions #5A and #7 on reverse side) Total Assessed Valuation + Director's Ratio = Equalized Assessed Valuat! $. o™ §. I Director's Ratio is less than 100%, the equaled ‘Valuation will be an amount greater than the i value. If Director's Ratio is equal to or In valuation. ‘excess of 100%, the assessed velue wii! be equal to the equatized (4) FULL EXEMPTION FROM FEE (See instniction #8 on reverse side) Deponent states that this deed transaction is fully exempt from the Realty Trai er Fee imposed by C. 48, P.L. 1968, a8 amended through C. 66, P.L. 2004, fort the fenowing reason(s). ves reference to exemption . (5) PARTIAL EXEMPTION FROM FEE (See instruction #9 on NOTE: All boxes below apply to grantor(s) only, ALL BOXES ‘void claim for partial exemption. Deponent claims that this Fee, and General Purpose Fee, a3 applicable, imposed reason(s) ATE CATEGORY MUST BE CHECKED. Failure to do so will Oh is exempt from State portions of the Basic Fee, Supplemental 1975, G. 113. P.L. 2004, and C, 66, PL.

rpose Fee, a3 applicable, imposed reason(s) ATE CATEGORY MUST BE CHECKED. Failure to do so will Oh is exempt from State portions of the Basic Fee, Supplemental 1975, G. 113. P.L. 2004, and C, 66, PL. 2004 for the following A | SENIOR CITIZEN Grantor(a) {_ 62 years ‘oF Over. * (See instruction #9 on reverse side for A or 8) 8. BLINDPERSON — Grantor(s) (_, DISABLED PERSON Grantor(s) {~ per d totally disabled [~ Receiving disability payments [~ Not gainfully employed” ons must also maet all of the following criteria: at time of sale. Cc Resident of State of New Jersey. be One or two-family resi Ises. rm Owners as joint tenants must all qualify. “IN THE CASE OF HUSBA , PARTNERS IN A CIVIL UNION COUPLE, ONLY ONE GRANTOR NEEDS TO QUALIFY IF TENANTS BY THE ENTIRETY. c HOUSING (See instruction #9 on reverse side) to H.U.D, standards. im Reserved for occupancy. irements of region, C Subject to resale controls. Tastructions #2, #10 and #12 on reverse S106) ii ly new improvement = ‘ss previously occupied T Not piiyiously used for any purpose. . {5 FNEW CONSTRUCTION’ printed clearly at \ wih _/the top of the first page of the deed. (7) Deporient makes this Affidavit to induce county accordance with the provisions of Chapter 48, P.L. 1 fd tha deed and accept the fea submitted herewith in 33, P.L. 2008. Beatrice Cesario Grantor Name 7 _16] Pleasant Valley Ri., W. Orange Granlor Address at Time of Sale ‘Subscribed and swom to before me this 12 dayot Jammary .20 02 A Notary Public of New Jersey oy o erent te My Commission Expires December 18, “—S0 Deed Dated Va 28 OB — Dato Reser County Recording Officers shalt forward one copy af each Affidavit of Consideration for Use by Seller when Section 3A is completed. ‘STATE OF NEW JERSEY- DIVISION OF TAXATION PO BOX 261 ‘TRENTON, NJ 08685-0251 ATTENTION: REALTY TRANSFER FEE UNIT ‘The Director of the Division of Taxation in the Department of the Trsasury has prescribed this form as required by law, and may not be aliared or amended without prior approvel of the Director. For Information on the Realty Transfer Fee or to print 8 copy of this Affidavil, visil the Division of Taxation website at: wvew.state.n].usftreseuryitaxation/iptiocaltax.htm,