Fill and Sign the New York State Department of Taxation and Finance Tp 584 I Form

TP-584(10/96) New York State Department of Taxation and Finance Combined Real Estate Transfer Tax Return and Credit Line Mortgage Certi®cate Recording Of®ce Time Stamp See instructions (TP-584- I) before completing this form. Please print or type. Schedule A Ð Information Relating to Conveyance Grantor hIndividual hCorporation hPartnership hOtherName (if individual; last, ®rst, middle initial) Mailing address City State ZIP codeSocial Security Number Social Security Number Federal employer ident. number Grantee hIndividual hCorporation hPartnership hOtherName (if individual; last, ®rst, middle initial) Mailing address City State ZIP codeSocial Security Number Social Security Number Federal employer ident. number Location and description of property conveyed Tax map designation Section Block Lot Address City/Village To w n County Type of property conveyed (check applicable box) 1h1 - 3 family house 2hResidential cooperative 3hResidential condominium 4hVacant land5hCommercial/Industrial 6hApartment building 7hOf®ce building 8hOther Date of conveyance month day year Percentage of real property conveyed which is residential real property % (see instructions) Condition of conveyance (check all that apply) a. ±Conveyance of fee interest b. ±Acquisition of a controlling interest (state percentage acquired %) c. ±Transfer of a controlling interest (state percentage transferred %) d. ±Conveyance to cooperative housing corporation e. ±Conveyance pursuant to or in lieu of foreclosure or enforcement of security interest (attach Form TP-584.1, Schedule E) f. ±Conveyance which consists of a mere change of identity or form of ownership or organization (attach Form TP-584.1, Schedule F) g. ±Conveyance for which credit for tax previously paid will be claimed (attach Form TP-584.1, Schedule G) h. ±Conveyance of cooperative apartment(s) i. ±Syndication j. ±Conveyance of air rights or development rightsk. ±Contract assignment l. ±Option assignment or surrender m. ±Leasehold assignment or surrender n. ±Leasehold grant o. ±Conveyance of an easement p. ±Conveyance for which exemption from transfer tax is claimed (complete Schedule B, Par tIII) q. ±Conveyance of property partly within and partly without the state r. ±Other (describe) Schedule B Ð Real Estate Transfer Tax Return (Article 31 of the Tax Law) PartI± Computation of Tax Due 1Enter amount of consideration for the conveyance (if you are claiming a total exemption from tax, check the exemption claimed box, enter consideration and proceed to Part III)............... Exemption claimed1 2Continuing lien deduction (see instructions if property is taken subject to mortgage or lien) ..........2( ) 3Taxable consideration (subtract line 2 from line 1) ....................3 4Tax: $2 for each $500, or fractional part thereof, of consideration on line 3...........4 5Amount of credit claimed (see instructions and attach Form TP-584.1, Schedule G) ..........5( ) 6Total tax due* (subtract line 5 from line 4) .........................6 PartII± Computation of Additional Tax Due on the Conveyance of Residential Real Property for $1 Million or More 1Enter amount of consideration for conveyance (from PartI, line 1)................1 2Taxable consideration (multiply line 1 by the percentage of the premises which is residential real property; see instructions) ....2 3Total additional transfer tax due* (1% of line 2) ......................3 *Please make check(s) payable to the county clerk where the recording is to take place or if the recording is to take place in New York City, make check(s) payable to the NYC Department of Finance . If no recording is required, send this return and your check(s) made payable to the Department of Taxation and Finance , directly to the NYS Tax Department, TTTB-Transfer Tax, PO Box 5045, Albany NY 12205-5045. For recording of®cer's use Amount received Par tI$ Par tII$ Date received Transaction number