Draft_October 2025_West Orange_HEFSP_with Appendices

GIT/REP-3 . State of New Jersey (12-07) Seller's Residency Certification/Exemption (C.55, P.L. 2004) (Please Print or Type) SELLER(S) INFORMATION (see Instructions, page 2): Name(s) Project Live, Inc. Current Resident Address 465-475 Broadway City, Town, Post Office Newark State NJ Zip Code 07104 PROPERTY INFORMATION (Brief Property Description): Block(s) 159.06 Lot(s) 38 Qualifier _ Street Address 97 Edgewood Avenue City, Town, Post Office West Orange State NJ ZipCode 07052 Seller's Percentage of Ownership_100% _ Consideration $1.00 Closing Date December 12, 2008 SELLER'S ASSURANCES (Check the Appropriate Box) (Boxes 2 through § apply to NON-residents): 1 O I am a resident taxpayer (individual, estate or trust) of the State of New Jersey pursuant to N.J.S.A. 54Ac1-k et seq. and will file a resident gross income tax return and pay any applicable taxes on any gain or income from the disposition of this property. 20 ‘The real property being sold or transferred is used exclusively as my principal residence within the meaning of section 121 of the federal Internal Revenue Code of 1986, 26 U.S.C. s. 121. 3 O { ama mortgagor conveying the mortgaged property to a mortgagee in foreclosure or in a transfer in lieu of foreclosure with no additional consideration. 40 Selier, transferor or transferee is an agency or authority of the United States of America, an agency or authority of the State of New Jersey, the Federal National Mortgage Association, the Federal Ilome Loan Mortgage Corporation, the Government National Mortgage Association, or a private mortgage insurance company. Seller is not an individual, estate or trust and as such not required to make an estimated payment pursuant to N.J.S.A.544:5-1-1 et seq. 6. & ‘The total consideration for the property is $1,000 or less and as such, the seller is not required to make an estimated payment pursuant to NJ.S.A. 54A:5-1-1 et seq- 7 O The gain from the sale will not be recognized for Federal income tax purposes under LR.C. Section 721, 1031, 1088 or is a cemetery plot. (CIRCLE THE APPLICABLE SECTION.) If such section does not ultimately apply to this transaction, the seller acknowledges the obligation to file a New Jersey income tax return for the year of the sale (see instructions). a No non-like kind property received. s O ‘Transfer by an executor or administrator of a decedent to a devisee or

to file a New Jersey income tax return for the year of the sale (see instructions). a No non-like kind property received. s O ‘Transfer by an executor or administrator of a decedent to a devisee or heir to effect distribution of the decedent’s estate in accordance with the provisions of the decedent's will or the intestate laws of this state. SELLER(S) DECLARATION: _ The undersigned understands that this declaration and its contents may be disclosed or provided to the New Jersey Division of Taxation and that any false statement eontained herein could be punished by fine, imprisonment, or both. I furthermore declare that I haye examined this declaration and, to the best of my knowledge and belief, it is true, correct and complete. X December 12, 2008 A Date Project Live, Inc. Signature (Geller) Please ingicate if Power of Attorney or Attorney ta Fact. Sate ~ Signature (Seller) Please indicate if Power of Attorney or AUarney in Fact i ificati i Printed by ALL-STATE LEGAL® 1647 — Geller’s Residency Certification/Exemption Powered by Pr oy AT STATE taternation@, Ine GIDREPS HotDocs' arww-aslegal.com 800.222.0510 Pagel Rev. 12/07 = P2/08