153-18 Exhibit A to Resolution Authorizing Cancellation of Taxes on 665 Eagle Rock Avenue.pdf

GITREP-3 (9-2015) . State of New Jersey SELLER’S RESIDENCY CERTIFICATION / EXEMPTION SELLER'S INFORMATION: Seller's Name: 665 Realty Management, LLC Current Residence Address: 26 South Valley Road, West Orange, NJ 07052 PROPERTY INFORMATION: Block: 176.03 Lot: 10 Qualifier: Address: 665 Eagle Rock Avenue, West Orange, NJ 07052 Seller's Percentage of Ownership: 100% Total Consideration: $400,000.00 Owner's Share of Consideration: $400,000.00 Closing Date: . February 28, 2018 1. oN Dea 42. 13. 14. SELLER ASSURANCES (Check the Appropriate Box) (Boxes 2 through 8 apply to Residents and Non-residents) xX Seller is a resident taxpayer (individual, estate, or trust) of the State of New Jersey pursuant to the New Jersey Gross income Tax Act 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. The real property being sold or transferred is Used exclusively as a principal residence as defined in, 26 U.S.C. s. 121. Seller is a mortgagor conveying the mortgaged property to a mortgagee in foreclosure or in a transfer in lieu of foreclosure with no additional consideration. Seller, 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 Home 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 gross income tax payment. The total consideration for the property is $1,000 or less and as such, the seller is not required to make an estimated income tax payment. ‘The gain from the sale will not be recognized for. Federal income tax purposes under 1.R.C, Section 721, (039) 1033 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). Seller did not receive non-like kind property... 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. ‘The

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. ‘The property being sold is subject to a short sale'instituited by the mortgagee, whereby the seller has agreed not to receive any proceeds from the sale and the mortgagee will receive all proceeds paying off an agreed amount of the mortgage. The.deed is dated prior to August 1, 2004), and was not préviously recorded. The real propérty.is being transferred under a relocation company transaction where a trustee of the relocation company buys the property from the seller and then sells the house to a third party buyer for the same price. The teal property is being transferred between spouses or incident to a divorce decree or property settlement agreement under 26 U.S. Code section 1041. The property transferred is a cemetery plot. The seller-is not receiving net proceeds from the sale.. Net proceeds from the sale means the net amount due to the seller on the Settlement sheet. 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 contained herein could be punished by fine, imprisonment, or both. | furthermore declare that 1 have examined this declaration and, to the best of my knowledge and belief, it is true, correct and complete. . By checking this box -o | certify that a Power of Attorney to represent the seller(s) has been previously recorded or is being recorded simultaneously with the deed to which this form is attached. Date: February 28, 2018 Wer Signature: SUNNY UBEROI!, Member