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Get and Sign Peconic Bay Region Form Instructions 1999
Number
❑
❑
❑
❑
Mailing address
Social Security Number
`
City
State
City
ZIP code
State
Location and description of property conveyed
Tax map designation
Dist
Section Block
Lot
ZIP code
Address
Federal employer ident. number
Federal employer ident. number
Village
Town
Type of property conveyed (check applicable box)
❑ Improved
Date of Conveyance
Date of Conveyance
Dual Towns:
❑ Vacant Land
MONTH
a. - Conveyance of fee interest
b. - Acquisition of a controlling interest...
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