Draft_October 2025_West Orange_HEFSP_with Appendices

MUST SUBMIT IN DUPLICATE NC1645 - Affidavit of Consideration RTF-1 (Rev. 7/08) P9y08 STATE OF NEW JERSEY AFFIDAVIT OF CONSIDERATION FOR USE BY SELLER {Chapter 49, P.L. 1968, as amended through Chapter 33, P.L. 2006) (NU.S.A. 46:15-5 et seq.) BEFORE COMPLETING THIS AFFIDAVIT, PLEASE READ THE INSTRUCTIONS ON THE REVERSE SIDE OFTHIS FORM. Printed by ALL-STATE LEGAL®& wew.aslegalcom 800.222.0510 Page 1 STATE OF NEW JERSEY } gs Comyn ar FOR RECORDERS USE ONLY ; . ode onsideration _. COUNTY OF pecey A772. RIF paid by seller $ vA Date (2/7/08 By — PG Municipality of Property Location: West Orange t Use symbol “C” to indicate that fee is exclusively for county use. (1) PARTY OR LEGAL REPRESENTATIVE = (See Instructions 3 and 4 attached) Deponent, Rey. Robert Cormier , being duly sworn according to law upon his/her oath deposes {Name) and says that he/she is the President and Grantor inadeed dated 12/12/08 (Grantor, Grantee, Loyal Reprnentative, Corporate Officer, Officer of Tit Go, Lending tnatitvtian, ete.) transferring real property identified as Block No. 159.06 Lot No. 38 located at 97 Edgewood Avenue, West Orange, New Jersey 07052 and annexed thereto. (Biceet Address, Town) (2) CONSIDERATION; $1.00 (See Instructions 1 and 5) (3) Property transferred is Class 4A 4B 4C (circle one). If Class 4A, calculation in Section 3A is required. (A) REGUIRED CALCULATION OF EQUALIZED VALUATION FOR ALL CLASS 4A COMMERCIAL PROPERTY TRANSACTIONS: (see Instructions 5A and 7) Total Assessed Valuation + Director's Ratio = Equalized Assessed Valuation $ + % = $ If Director's Ratio is lees than 1004, the equalized valuation will be an amount greater than the assessed value. [f Director's Ratio is equal to or in oxcess of 100%, the assessed value will be equal to the equalized value. (4) FULL EXEMPTION FROM FEE: (see instruction 3) Deponent states that this deed transaction is fully exempt from the Realty Transfer Fee imposed by C. 49, P.L. 1968, as amended through C. 66, P.L, 2004, for the following reason(s). Mere reference to the exemption symbol is insufficient. Explain in detail. (a} For a consideration of less than $100.00 (5) PARTIAL EXEMPTION FROM FEE: (see Zastruction 9) NOTE: Au boxes below apply te grantor(s) only. ALL BOXES IN APPROPRIATE CATEGORY MUST BE CHECKED. Failure to do so will void claim for partial exemption. Deponent claims that this deed

Zastruction 9) NOTE: Au boxes below apply te grantor(s) only. ALL BOXES IN APPROPRIATE CATEGORY MUST BE CHECKED. Failure to do so will void claim for partial exemption. Deponent claims that this deed transaction is exempt from the State's portion of the Basic Fee, Supplementai Fee and General Purpose Fee, as applicable, imposed by C. 176, P.L. 1975; C. 113, P.L, 2004 and C. 66, P.L, 2004 for the following reason(s): A. SENIOR CITIZEN (see Instruction 9) oO Grantor(s) 62 years of age or over.* oO Owned and occupied by grantor(s) at time of sale. (CL One- or two-family residential premises. LJ) Owners as joint tenants mast all qualify. {_] Resident of the State of New Jersey. B. BLIND (see Instruction 9) DISABLED (see Instruction 9) oO Grantor(s} legally blind.* oO Grantor(s) permanently and totally disabled.* [1] One- or two-family residential premises. oO Reeeiving disability payments.” Oo Owned and occupied by grantor(s) at time of sale. oO Not gainfully employed.* oO Owners as joint tenants must all qualify. (_} One- or two-family residential premises. (1) Resident of the State of New Jersey. [([] Owned and occupied by grantor(s) at time of sale. * IN THE CASE OF HUSBAND AND WIFE, PARTNERS IN A 0 Owners as joint tenants must all qualify. GOALITY [OWNED ASTENANTS SY THE ENTIRETY, LJ Resident ofthe State of New Jersey. C. LOW AND MODERATE INCOME HOUSING (see /nstruction 9) (X] Affordable according to HUD standards. DX] Reserved for occupancy. [x] Meets income requirements of region. [x] Subject to resale controls. (6) NEW CONSTRUCTION (see Instructions 2, 10 and 12} LJ Entirely new improvement. J Not previously occupied. oO Not previously used for any purpose. CJ “NEW CONSTRUCTION” printed clearly at the top of the first page of the deeds ummnenge takes this Affidavit to induce the County Clerk or Register of Deeds to record the deed and accept the fee submitted herewith in accordance with the provisions of Chapter 49, P.L, 1968, as amended through Chapter 33, P.L. 2006. Subscribed and sworn to before me Rev, Robert Cormier this Twelfth Bugnature of Deponent Grantor Name December 20.08 St. Rosa Lima Church day of 411 Gray Street, Newark, NJ Deponent Address Grantor Address at Tima of Sale XXX-XXK-X Jeffrey R. Kuschner, Esquire Last 3 digits in Grantor's Sociat Security Ne. Name/Company of Settlement Officer “This fore is p ‘the Director, Division of

ss Grantor Address at Tima of Sale XXX-XXK-X Jeffrey R. Kuschner, Esquire Last 3 digits in Grantor's Sociat Security Ne. Name/Company of Settlement Officer “This fore is p ‘the Director, Division of Taxation in ‘OR LPEFICIAL USE ONLY the Departent of the Treasury, as required by Taw. and msY | Fs ument Number {f/f b GA al of the Coumy SSCL not be altered ended witbort the prior approv m - Director. Por information on the Really Transfer Fee or to print | Deed Nurnber Book /) { 7 Q) _ Pare f c7 2 copy of this Affidavit, visit the Division of Taxation webite at | Deog Dated >. ~ Date Recorded wow state.nj.uaftreasury/taxstion/Iptlocaltax. htm fi2pak- —_ County Recording Officers shall forward one State of New Jersey — Division of Taxation, i i / jon 3A is completed. ‘of each Affidavit of Consideration for Use by Seller when Section i ion PO. Box 251, Trenton, NJ 08695-0254, Attention: Realty Transfer Fee Unit