252-26 Deed.pdf

GIT/REP-3 State of New Jersey (8-25) * % 7 i . 7 (Fiat Typeh Seller's Residency Certification/Exemption Seller’s:Information Name(s) AMALIA LACERTOSA Current Street Address 165 Barbara Court City, Town, Post Office State ZIP Code Spotswood NJ 08884 Property Information Block(s) Lot(s) Qualifier 142 21 Street Address 102 Elm Street City, Town, Post Office State ZIP Code West Orange NJ 07052 Seller's Percentage of Ownership Total Consideration Owner's Share.of Closing Date 25 $350,000.00 « $87,500:00._ SK 's Assurances (Check the Appropriate Box) (Boxes 2 through 16 apply to Residents and Nonresidents 1. El Seller is a resident taxpayer (individual, estate, or trust) of the State of New Jersey pul (thie New Jersey Gross Income Tax Act, will fle a resident Gross Income Tax return, and will pay any applicable taxes on any gain or Income from the disposition of this property. The real property sold or transferred is used exclusively as a principal residengg as definéd'in 26 U.S. Code section 121. See instructions. 3. Seller is a mortgagor conveying the mortgaged property to a mortgagee in foredlosure/or in a transfer in lieu of foreclosure with no additional consideration. — 4 Seller, transferor, or transferee is an agency or authority of the United St teBof 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. 5. Seller is not an individual, estate, or trust and is not required to m in @stimated Gross Income Tax payment. 6. The total consideration for the property is $1,000 or less softhe Belle jot required to make an estimated Income Tax payment. Ta. The gain from the sale is not recognized for federal incorhe ta purbdses under 26 U.S. Code section 721, 1031, or 1033 (CIRCLE THE APPLICABLE CODE SECTION). If the indicated sggtigode not ultimately apply to this transaction, the seller acknowledges the obligation to file a New Jersey Income Tax return for it ‘the sale and report the recognized gain. See instructions. Seller only received like-kind property. The real property is being transferred by an executonor ‘administrator of a decedent to a devisee or heir to effect distribution of the decedent's estate in accordance with the provisidnsfithe decedent's will or

operty is being transferred by an executonor ‘administrator of a decedent to a devisee or heir to effect distribution of the decedent's estate in accordance with the provisidnsfithe decedent's will or the intestate laws of this State. The real property being sold is subject to@ Short salestituted by the mortgagee, whereby the seller agreed not to receive any proceeds from the sale and the mortgagee will raceive all proceeds paying off an agreed amount of the mortgage. 10. The deed is dated prior to August 1, 2004%and was not previously recorded, 11. The real property is being transferged 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. 12, The real property is being transfefre between ‘spouses or incident to a divorce decree or property settlement agreement under 26 U.S. Code section 1041. 13. The property transferred hee plot. 14, The seller is not recefVi5g? eds from the sale. Net proceeds from the sale means the net amount due to the seller on the settlement sheet. The seller is a retirement truSt that received an acknowledgment letter from the Internal Revenue Service that the seller is a retirement trust, and is therefore not required to make the estimated Gross Income Tax payment. The seller (and/or spouse/civil union partner) originally purchased the property while a resident of New Jersey as a member of the U.S. Armed Forces and is now selling the property as 4 result of being deployed on active duty outside of New Jersey. (Only check this box if applicable and neither boxes 1 nor 2 apply.) 15. OOocopo0oc oo oo oo 16. Seller’s Declara’ 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 may be punished by fine, imprisonment, or both. [furthermore declare that | have examined this declaration and, tothe best of my knowledge and belie, itis true, correct and complete. By checking this box [_] | certiy that a Power of Attorney to represent the seller(s) has been previously recorded or is being recorded simultaneously with the deed fo which this fornyis atta¢hed. at * Amalie Jgcedl Fa Daté Signature (Seller) _Indicate if Power of Attorney or Attorney in Fact Date Signature

ed or is being recorded simultaneously with the deed fo which this fornyis atta¢hed. at * Amalie Jgcedl Fa Daté Signature (Seller) _Indicate if Power of Attorney or Attorney in Fact Date Signature (Seller) Indicate if Power of Attorney or Attorney in Fact