Draft_October 2025_West Orange_HEFSP_with Appendices

GIT/REP-3 (5-12) State of New Jersey SELLER'S RESIDENCY CERTIFICATION/EXEMPTION (C55, PL. 2004) {Ptease Print or Type} SELLER(S} INFORMATION (See Instructions, Page 2} Names(s} THE ARG OF ESSEX COUNTY, ING. ‘Current Resident Address 123 NAYLON AVENUE Street: . City. Town, Post Office State Zip Code LIVINGSTON NJ ; 07039 Block{s) Lat(s) . Qualifier 155 27 CO177 . Street Address: 177 MARION DRIVE aN City. Town, Post Office ~ - 7 Slate Zip Gode WEST ORANGE NJ 07052 Seller's Percentage of Ownership Consideration 5 Closing Date 100 100 ; 08/17/2018 SELLER ASSURANCES (Check the Appropriate Box) (Boxes 2 through 10 apply to Residents and Non-residents} Li am a resident taxpayer (individual, estate, or trust} of Ihe State of New. Jersey pursuant to N J.S A. 54A:1-4 et seo. and wil fle a resident gross income tax reiurn and pay any applicable laxes on any géin of incame Irom the dispositian of this oroperty. 2 [_JThe teal property being sold or transferred is used exclusively as my ‘pnicipal residence within the meaning af section 121 of the federal Internal Revenue Code af 1986, 26 U.S.C. s. 121 . 3. [lam a mongagor conveying the mortgaged property to a morgage in foreclosure of in a transfer in lieu of foreclosure wilh no additional consideration » ()Sclter, transferor or transferee is an agency or authority ofthe United States ct America, an agency or authority of the State of New Jersey, the Federal National Mortgage Association; the Federal Home Loan Mortgage Corporation. the Government National Mortgage Association, or a private mortgage insurance company. eller is not an indiv:dual, estate or trust and as such not required to make an estimaied payment pursuant to N.J.S.A.54A:1-1 et seq . tne tatal consideration lor the property is $1,000 or less and as such, the seller is not required to make an eslimated payment pursuant (0 N.J.S.A. 54A:5-1-1 et seq. 7, |" ]The gain fron the sale will not be recognized for Federal income tax purposes under 1 R.C. Section 721, 1031, 1033 or is a cemelery plot. (CIRCLE THE APPLICABLE SECTION} If such seclion dues not ultimately apply to this transaction, the seller acknowledges the obligation to fite a New Jersey ineorhe tax seturn for the year of the sale (see instructions). LIN non-like kind propeniregenvd. * 8. [[]Transter by an executor or administcator of a decedent to a devise or heir to effect

w Jersey ineorhe tax seturn for the year of the sale (see instructions). LIN non-like kind propeniregenvd. * 8. [[]Transter by an executor or administcator of a decedent to a devise or heir to effect distribution of the decedent's cstate in accordance with the provisions of the decedent's will or the intestate laws of this state. 3 Cthe property being sold is subject to a shor sale instituled by the mongagee, whereby the seller has agreed not to recewe any proceeds from the sale ang the mortgagee will receive all proceeds paying off an agreed amount of the mortgage 10. C}tne deed being recorded is a deed dated priar (o the effective date of Pl. 2004, c. 66 (August 1, 2004), and was proviously unrecorded. SELLER(S) DECLARATION The undersigned understands that [his declaralon and its contents rray be disclosed nr prowded to the New Jersey Division of Taxation and that any false statement cantained herein cauld be punished by fine. imprisonment, ar bolt. | furthermore declare that [have exarined this declaratior and. lo the bes! of my knovdedge and belie! itis true. comect and complete. By checking this box O | certify that the Power r of Attorney lo represent the selter(s) has been previously recordad or 1s being cecorded simullangously with the deed to which this form is atta 06/1 7/2014 Date _ ~~ mgnalure (Seller) Pioase nei cate # Power at Auotray of Anomnay in Fact Date ~~ ~~ . Signatuce {Seller} Please indicate # Power ol Acniney ar Artumey in Fact