219-22 Exhibits - Execution of Deed and Closing Document for Sale of Lot to Valerie Ford - August 2022.pdf

RTF-1 (Rev. 3/2/22) MUST SUBMIT IN DUPLICATE STATE OF NEW JERSEY AFFIDAVIT OF CONSIDERATION FOR USE BY SELLER (Chapter 49, P.L.1968, as amended through Chapter 33, P.L. 2006) (N.J.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 ae FOR RECORDER'S USE ONLY Consideration $ 'SS. County Municipal Code RIF paid by seller § COUNTY ESSEX 0722 Date, By MUNICIPALITY OF PROPERTY LOCATION __WEST ORANGE *Use symbol 'C" to indicate that fee is exclusively for county use. (1) PARTY OR LEGAL REPRESENTATIVE (See Instructions #3 and #4 on reverse side) Deponent, ROBERT D. PARISI being duly swom according. to. = law upon his/her_— oath, (Name) deposes and says that he/she is the__CORPORATE OFFICER inadeed dated ___AUGUST _, 2022 _ transferring (Grantor, Legal Representative, Corporate Officer, Officer of Titte Company, Lending Institution, etc.) real property identified as Block number 175.08, Lot number 14 located at MELLON AVENUE, WEST ORANGE and annexed thereto. (Street Address, Town) (2) CONSIDERATION $,$,000.00___(instructions #1 and #5 on reverse side) []no prior mortgage to which property is subject. (3) Property transferred is Class 44 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) PROPERTY TRANSACTIONS: (See instructions #5A and #7 on reverse side) Total Assessed Valuation + Director's Ratio = Equalized Assessed Valuation + % = $. Hf Director's Ratio is less than 100%, the equalized valuation will be an amount greater than the assessed value. {f Director's Ratio is equal to or in excess of 100%, the assessed value will be equal to the equalized valuation, (4) FULL EXEMPTION FROM FEE (See Instruction #8 on reverse side) Deponent states that this deed transaction is fully exempt from the Realty Transfer Fee imposed by C. 49, P.L. 1968, as amended through C. 66, P.L. 2004, for the following reason(s). Mere reference to exemption symbol is insufficient. Explain in detail. {b) By or to the United States of America, this State, or any instrumentality, agency or subdivision (5) PARTIAL EXEMPTION FROM FEE ( instruction #9 on reverse side) NOTE: All boxes below apply to grantor(s) only. ALL BOXES IN APPROPRIATE CATEGORY MUST BE CHECKED. Failure to

, agency or subdivision (5) PARTIAL EXEMPTION FROM FEE ( instruction #9 on reverse side) NOTE: All boxes below apply to grantor(s) only. ALL BOXES IN APPROPRIATE CATEGORY MUST BE CHECKED. Failure to do so will void claim for partial exemption. Deponent claims that this deed transaction is exempt from State portions of the Basic, Supplemental, and General Purpose Fees, as applicable, imposed by C. 176, P.L. 1975, C. 113, P.L. 2004, and C. 66, P.L. 2004 for the following reason(s): A ‘SENIOR CITIZEN Grantor(s) [] 62 years of age or over.* (Instruction #9 on reverse side for A or B) B. BLIND PERSON Grantor(s) [1 legally blind or; * DISABLED PERSON —Grantor(s)_ [J permanently and totally disabled [1 receiving disability payments not gainfully empioyed* Senior citizens, blind persons, or disabled persons must also meet all of the following criteria: (lowned and occupied by grantor(s) at time of sale. DiResident of State of New Jersey. Clone or two-family residential premises. Downers as joint tenants must all qualify. “IN CASE OF HUSBAND AND WIFE, PARTNERS IN A CIVIL UNION COUPLE, ONLY ONE GRANTOR NEED QUALIFY IF TENANTS BY THE ENTIRETY, Cc. LOW AND MODERATE INCOME HOUSING (Instruction #9 on reverse side) IF APPLIES ALL BOXES MUST BE CHECKED. CD Affordable according to H.U.D. standards, OO Reserved for occupancy. i Meets income requirements of region 1 Subject to resale controls. (6) NEW CONSTRUCTION (instructions #2, #10 and #12 on reverse side) IF APPLIES ALL BOXES MUST BE CHECKED. Ci Entirely new improvement (Not previously occupied. CO Not previously used for any purpose. CO"NEW CONSTRUCTION" printed clearly at top of first page of the deed, (7) RELATED LEGAL ENTITIES TO LEGAL ENTITIES (Instructions #5, #12, #14 on reverse side) F APPLIES ALL BOXES MUST BE CHECKED. No prior mortgage assumed or to which property is subject at time of sale. (No contributions to capital by either grantor or grantee legal entity. OiNo stock or money exchanged by or between grantor or grantee legal entities. (©) INTERCOMPANY TRANSFER IF APPLIES ALL BOXES MUST BE CHECKED. (Instruction #15 on reverse side) intercompany transfer between combined group members as part of the unitary business CiCombined group NU ID number (Required) (8) Deponent makes this Affidavit to induce county clerk or register of deeds to record the deed and accept the fee submitted herewith in

the unitary business CiCombined group NU ID number (Required) (8) Deponent makes this Affidavit to induce county clerk or register of deeds to record the deed and accept the fee submitted herewith in accordance with the Provisions of Chapter 49, P.L. 1968, as amended through Chapter 33, P.L. 2006. Subscribed and sworn to before me Township of West Orange this day of Aug uc 2002 ‘Signature of Deponent Grantor Name 66 Main St, West Orange, NJ $102 66 Main St, West Orange, NJ 0}02 Deponent Address Grantor Address at Time of Sale \ XXX-XX-X Gaccione Pomaco, P.C. Nobary fubhic Last three digits in Grantors Social Security Number “Name/Company of Seltlement Officer FOR OFFICIAL USE ONLY Instrument Number County Deed Number BOOK Page. Deed Dated Date Recorded County recording officers shall forward one copy of each RTF-1 form when Section 3A is completed to: STATE OF NEW JERSEY PO BOX 251 TRENTON, NJ 08695-0251 ATTENTION: REALTY TRANSFER FEE UNIT