Draft_October 2025_West Orange_HEFSP_with Appendices

GITREP-3 B42} State of New Jersey SELLER'S RESIDENCY CERTIFICATION/EXEMPTION {C.55, PL, 2004) SELUER(S)'INFORMATION((SeelinsiructionssPage-2)iur Names(s} veannette Whaley and Mark Whaley ‘Current Resident Address: : Street 54 Summit Drive _ ; _ — : - City, Town, Post Offica State Zip Code Basking Ridge yy o7920 Block(s} Lots} . Quaiifier 195 27 COI77 . Street Address: ~ : : ~ ~ 177 Manion Drive aN . City, Tows, Post Office ° ~ 7° Slave "Zip Code West Orange a. a oo Ns _ : 07082 Solier's Percentage of Ownership Consideration : Closing Date DID Gpd ov SELLER ASSURANCES (Chéckithe Appropriate.Box) (Boxes 2(throughd O:apply:ta'Residents/and:Nonzresidents): 1. Blam aresident taxpayer (individual, estate, of trust) of te State of New Jersey pursuant to NUJS.A. 54A:1-1 et seq. and will file a resivent gross ingore tax return and pay any applicab'e taxes on affy gain or incanie from tre cisposition of this properly. Qe Chtte veal property being sold or tracsterrcd .s used excius vely a8 my-princ.pal res:dence withi: tne meaning of section 127 of the federal Internal Reverve Code of 1986, 26U.S.C.s. 121. < Ny 3. [Jl am a mortgagor conveying the rrongaged property to amortgeyee in foreciosu’e ar in a transfer in lieu of foreciosure with no atlditional cansideration. 4. []Seher, transferor or transferee is an agency or authonty of the United States of America, an agency or authority of the State of New Jersey. the Federai National Mortgage Association, the Federal Home Loa Morigage Corporatien, the Goverarrent National Morigage Association, or a private morigage inssrance company. 5. [Sel:er is not an ind vidal. estate or (rust ad as stich not required to make a2 estimated payment pursuant to N..S.A.54A:1-1 et seq, 6. [Je total consideration for the praperty 15 $4.4406 6° fess ond as such, the seer is not requirea to make ar estimated payment pursuant to N.J.S.4, 54A:5-1-1 et seq. > 7. The gain from the sale wil sot be recognized for Feveral income tax purposes under LR.C. Section 721, 1031, 1033 or is a cemetery plot. (CIRCLE THE APPLICABLE SECTION). ff such section does not ultmate’y apply to this iravsaction, ihe seile: acknowledges the obligation to Fle a New Jersey income tax return for the year of the sale (see instructions). Do con-tike kind proparty reesived. 8. [[fTranster by an excuiityr cr administrator of a decedent 10 a cicvisee or heir

Fle a New Jersey income tax return for the year of the sale (see instructions). Do con-tike kind proparty reesived. 8. [[fTranster by an excuiityr cr administrator of a decedent 10 a cicvisee or heir ty effect distribution of the decedent's estate in accordance with the provisions ef ihe decedent's wi!l or the intestate laws of this slate. 9 Dre property being sold is subject to a shor sale inslituted by Lhe mortgagee. whereby the seller tas agreed not te ‘eceive any proceeds from the sa.c and ihe mortgagee will receive al oroceeds paying off an agrecd amount of the martgage. 10, Cthe ceed being recorded is 2 deed vated prior to the effective date of PL. 2004. c. 55 (August 1. 2004), ana was prev:ausly usvecorded SELUER(S)};DECLARATION.":: The undersigned understands that t's ceclaralias a ils contenls may be disclosed ot provided to the Now Jetsey D'vision of Taxation and that any false statemers conlained nerein rou'd be punished by ‘inc. morisoneren:. @° beth. | furthermore declare that have exarined this declaration ard, to whe dest at my knowledge and belie! irs ve, co:rect and complete. By checking Iris ox G_ | certify that se Power of Attorney Ip represent the se! has heen previously éecordac oF is 2eing recorded simmullaneously ‘lh the deed! to which ibis “ot:r 1s attached. — sfyfis Dt arherhatey Date {43 _ Date ‘Selict} Plaasy i:dkga'e it Power of Att Aorney in Fact Signature iSeler) Please “sl cate It Power of Axorsey or Aomay m Fac