Draft_October 2025_West Orange_HEFSP_with Appendices

AYTP-1 (Rev, 2/19/07) STATE OF NEW JERSEY . Must SUBMIT-IN DUPLICATE AFFIDAVIT OF CONSIDERATION FOR USE BY SELLER "8 ‘(Chapter 49, P.L.1988, as amended through Chapter 33, P.L. 2006) (N.u.S.A. 46:15-5 et seq.) ‘ ‘BEFORE COMPLETING THIS ‘AFFIDAVIT, PLEASE READ THE INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORM. STATE OF NEW JERSEY ==. . FOR RECORDER’S USE ONLY | PL Y5s. cuynmagucon | Rate § COUNTY —y lad ___—| Date MUNICIPALITY OF PROPERTY LOCATION Lost atAnee *Use symbol “C" to Indicate that faa is exclusively for county use. (1) B lid IVE (See instructions #3 and #4 on reverse side) Deponent, l 24 a C 5 Kap Val being swom according to aw upon his/her cath, deposes and says that he/she Is the. in a deed dated Atal 20F _ transferring {Grantor, Legal Representative, Corporat Of Title ny, Lending Institution, etc.) real property identified as nm number 177.14 Lot number ZL z b 3 located at ty] Ac Asrnt Iz y éD. Ms é7 fleAssin q Uptlug annexed thereto. (Street Address, Town) (2) CONSIDERATION 30 290 (See instructions #1 and #5 on reverse side) {8) Property tranaterred is Ciass 4A 4B 4C (circle one). If property transferred is Class 4A, calculation in Section 3A below is required. (3A)REQUIRED CALCULATION OF EQUALIZED VALUATION FOR ALL CLASS 4A COMMERCIAL PROP! RANSACTICNS: (See Instructions #5A and #7 on reverse side) Total Assessed Valuation + Director's Ratlo = Equalized Assessed Valuation Yo = §. {f Director's Ratio is iss than 100%, the equalized valuation will be an amount greater than tha assess excess of 100%, the assaesed value will be aqual to the equalized valuation. actor's Ratlo is equal to or in C. 49, P.L. 1868, as amended through plain in detail. (5) PARTIAL EXEMPTION FROM FEE (See instruction #9 on reverse NOTE: All boxes below apply to grantor(s) only. ALL BOXES IN APPRO CATEGORY MUST BE CHECKED. Failure to do so will void claim for partlal exemption. Daponent claims that this deed4ransact pt from State portions of the Basic Fee, Supplementat Fee, and General Purpose Fee, as applicabla, imposed by C. 126;°P C. 113, P.L. 2004, and C. 66, P.L. 2004 for the following rpason(s): os . A SENIOR CITIZEN Grantor(s) C62 years of Siz* (See instruction #9 on reverse side for A or B) B. { BLIND PERSON Grantor(s) [| tegally blin DISABLED PERSON Grantor(s) L] permanent ally disabled [] Receiving disability payments [_] Not gainfully

(See instruction #9 on reverse side for A or B) B. { BLIND PERSON Grantor(s) [| tegally blin DISABLED PERSON Grantor(s) L] permanent ally disabled [] Receiving disability payments [_] Not gainfully employed" Senior citizens, blind persons, or disabl () _ Owned and occupied oO One or two-family res! must also meet all of the following criteria: 2 of sale. oO Resident of State of New Jersey. a] Owners as joint tenants must all qualify. *IN THE CASE OF HUSBAND Al UNION PARTNERS, ONLY ONE GRANTOR NEEDS TO QUALIFY IF TENANTS BY THE ENTIRETY. Cc. LOW AND MODERATE JME HOUSING {See instruction #9 on reverse side) A Affordable acc .U.D. standards. O Reserved for occupancy. Meets incor nts of region. oO _ Subject to resale controls. provement. im) Not previously occupied. ised for any purpose. oO “NEW CONSTRUCTION” printed clearly at ‘the top of the first page of the deed. {7) Deponent makes this Affidavit to induce county clerk or register of to record the deed and accept the fee submitted herewith in accordance with the provisions of Chaptar 49, P.L. 1968, as amended h Chapter 33, P.L. 2006. SSS EREY wor mesa Pliage Cesito Mt pore bo. PFetssant Uk hh by mnt Address: NV, Greg a of Sale yen Peper He Wis BE nse Last Sigs i Grantors Social Security Number Neme/Company af Setiament Oficer (opt Ue FOR OFFIGIAL USE ONLY rma instrument Humber County. NOTARY PUBLIC Deed Deed TEBE — bese Racarzed MY COWBRSSION EXPIRES wy _— County Recording Officers shall forward one copy of aach Affidavit of Consideration for Use by Seller whan Section 3A Is completed. STATE OF NEW JERSEY- DIVISION OF TAXATION PO BOX 251 ‘TRENTON, NJ 08895-0251 ATTENTION: REALTY TRANSFEA FEE UNIT ~ ‘The Director at the Division of Taxation in the Department of the Treasury has prescribed this form as required by law, and may not bs altered or amended without prlor approval a of the Director. For Information on the Aealty Transfer Fee or ta print a copy of this Affidavit, visit the Division of Taxation wabsite at: www.state.n).ustranauryftaxationfiptiocattax.htm.