Combined Real Estate Transfer Tax Return Mortgage Certificate Certification Of Exemption {TP-584}

Department of Taxation and FinanceCombined Real EstateTransfer Tax Return,TP-584 (7/19)Instructions for Form TP-584,Condition of conveyance a. þ Conveyance of fee interestb. þ Acquisition of a controlling interest (state percentage acquired þ %)c. þ þ Transfer of a controlling interest (state þ percentage transferred þ þ %)d. þ Conveyance to cooperative housing corporatione. þ Conveyance pursuant to or in lieu of foreclosure or enforcement of security interest Grantor/Transferor þ Individual þ Corporation þ Partnership þ Estate/Trust þ Single member LLC þ OtherGrantee/Transferee þ Individual þ Corporation þ Partnership þ Estate/Trust þ Single member LLC þ Other þ Name þ X þ Social Security number þ Mailing address þ Social Security number þ City þ State þ ZIP code þ EIN þ Single member EIN or SSN þ Name þ X þ Social Security number þ Mailing address þ Social Security number þ City þ State þ ZIP code þ EIN þ Single member EIN or SSNLocation and description of property conveyed þ f. þ Conveyance which consists of a mere change of identity or form of ownership or organization þ g. þ Conveyance for which credit for tax previously paid will be claimed þ h. þ Conveyance of cooperative apartment(s) þ i. þ Syndication þ j. þ Conveyance of air rights or development rights þ k. þ Contract assignment þ l. þ Option assignment or surrender þ m. þ Leasehold assignment or surrender þ n. þ Leasehold grant þ o. þ Conveyance of an easement þ p. þ Conveyance for which exemption from transfer tax claimed þ q. þ Conveyance of property partly within and partly outside the state þ r. þ Conveyance pursuant to divorce or separation þ s. þ Other Tax map designation 226 þ SWIS code þ Street address þ City, town, or village þ County þ Section, block & lot þ (six digits)Type of property conveyed X1 þ One- to three-family house þ 5 þ Commercial/Industrial þ Date of conveyance2 þ Residential cooperative þ 6 þ Apartment building þ 3 þ Residential condominium þ 7 þ 4 þ Vacant land þ 8 þ OtherPercentage of real property conveyed which is residential real property þ % þ month þ day þ year þ þ Amount received þ Date received þ Transaction number þ Schedule B, Part 1 $ þ Schedule B, Part 2 $ þ Single member222s name if grantor is a single member LLC þ Single member222s name if grantee is a single member LLC American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 4 þ TP-584 (7/19)Part 3 226 Explanation of exemption claimed on Part 1, line 1 The conveyance of real property is exempt from the real estate transfer tax for the following reason:a. þ Conveyance is to the United Nations, the United States of America, New York State, or any of their instrumentalities, agencies, þ or political subdivisions (or any public corporation, including a public corporation created pursuant to agreement or compact þ with another state or Canada) þ. ............................................................................................................................................................ þ ab. þ Conveyance is to secure a debt or other obligation............................................................................................................................ þ b þ þ. ............................... þ cd. þ Conveyance of real property is without consideration and not in connection with a sale, including conveyances conveying þ. ....................................................................................................................................................................... þ de. þ Conveyance is given in connection with a tax sale............................................................................................................................. þ e þ ownership. (This exemption cannot be claimed for a conveyance to a cooperative housing corporation of real property comprising the cooperative dwelling or dwellings.) Attach Form TP-584.1, Schedule F þ. .................................................................... þ fg. þ Conveyance consists of deed of partition þ. ........................................................................................................................................... þ gh. þ Conveyance is given pursuant to the federal Bankruptcy Act............................................................................................................. þ h þ i. þ Conveyance consists of the execution of a contract to sell real property, without the use or occupancy of such property, or the granting of an option to purchase real property, without the use or occupancy of such property þ. ................................................. þ ij. þ Conveyance of an option or contract to purchase real property with the use or occupancy of such property where the consideration is less than $200,000 and such property was used solely by the grantor as the grantor222s personal residence and consists of a one-, two-, or three-family house, an individual residential condominium unit, or the sale of stock in a cooperative housing corporation in connection with the grant or transfer of a proprietary leasehold covering an individual residential cooperative apartment....................................................................................................................................... þ jk. þ Conveyance is not a conveyance within the meaning of Tax Law, Article 31, 247 1401(e) þ þ þ. ........................................................................................................................................................................... þ k(Tax Law, Article 31)Part 1 226 Computation of tax due þ 1 þ Enter amount of consideration for the conveyance þ þ þ. ................................ þ þ þ 2 þ Continuing lien deduction þ þ. .......................................... þ þ 3 þ Taxable consideration þ þ. ................................................................................................... þ þ 4 þ Tax: $2 for each $500, or fractional part thereof, of consideration on line 3 þ. ........................................................ þ þ 5 þ Amount of credit claimed for tax previously paid þ þ. ............... þ þ 6 þ Total tax due* þ þ. þ Part 2 226 Computation of additional tax due on the conveyance of residential real property for $1 million or more þ 1 þ Enter amount of consideration for conveyance þ þ. þ þ 2 þ Taxable consideration þ þ. ... þ þ 3 þ Total additional transfer tax due* þ þ. .................................................................................. þ * þ The total tax (from Part 1, line 6 and Part 2, line 3 above) is due within 15 days from the date of conveyance. Make check(s) payable to the county clerk where the recording is to take place. For conveyances of real property within New York City, use Form TP-584-NYC. If a recording is not required, send this return and your check(s) made payable to the NYS Department of Taxation and Finance, directly to the NYS Tax Department, RETT Return Processing, PO Box 5045, Albany NY 12205-0045. If not using U.S. Mail, see Publication 55, . American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 4 þ TP-584 (7/19)I (we) certify that: X1. þ The real property being sold or transferred is not subject to an outstanding credit line mortgage.2. þ The real property being sold or transferred is subject to an outstanding credit line mortgage. However, an exemption from the tax is claimed for the following reason: þ a þ The transfer of real property is a transfer of a fee simple interest to a person or persons who held a fee simple interest in the real property (whether as a joint tenant, a tenant in common or otherwise) immediately before the transfer. þ b þ The transfer of real property is (A) to a person or persons related by blood, marriage or adoption to the original obligor or property after the transfer is held by the transferor or such related person or persons (as in the case of a transfer to a trustee for þ þ þ d þ The maximum principal amount secured by the credit line mortgage is $3,000,000 or more, and the real property being sold or transferred is not principally improved nor will it be improved by a one- to six-family owner-