This document prepared by (and after recording
return to): )
)
)
)
)
)
)
-------- Above This Line Reserved For Official Use Only-------------Name:
Firm/Company:
Address:
Address 2:
City, State, Zip:
Phone:
QUITCLAIM DEED
(Individual to LLC)
KNOW ALL MEN BY THESE PRESENTS THAT:
FOR VALUABLE CONSIDERATION OF TEN DOLLARS ($10.00), and other good and
valuable consideration, cash in hand paid, the receipt and sufficiency of which is hereby acknowledged,
______________________________ , an Individual, married unmarried, hereinafter referred to as
“Grantor”, does hereby remise, release, and quitclaim unto ______________________________ , a
Limited Liability Company organized under the laws of the state of _______________ , hereinafter
“Grantee”, the following lands and property, together with all improvements located thereon, lying in the
County of ______________________ , State of New York, to-wit:
See Legal Description Attached as Exhibit A incorporated by reference as though set forth in full
Legal Description:
LESS AND EXCEPT all oil, gas and minerals, on and under the above described property owned
by Grantor, if any, which are reserved by Grantor.
SUBJECT to all easements, rights-of-way, protective covenants and mineral reservations of
record, if any.
GRANTOR, in compliance with Section 13 of the Lien Law, covenants that the Grantor will
receive the consideration for this conveyance and will hold the right to receive such consideration as a
trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the
same first to the payment of the cost of the improvement before using any part of the total of the same for
any other purpose.
TO HAVE AND TO HOLD same unto Grantee, and unto Grantee’s assigns forever, with all
appurtenances thereunto belonging.
Quitclaim Deed Page 1 of 3
WITNESS Grantor(s) hand(s) this the ____ day of ________________ , 20 ____ .
(1 st
Grantor’s Signature)
Print Name
CERTIFICATE OF ACKNOWLEDGMENT
Individual Capacity within the State of New York for Real Property
State of New York )
) ss.:
County of )
On the day of in the year before me, the undersigned,
personally appeared , personally known to me or proved to
me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within
instrument and acknowledged to me that he executed the same in his capacity , and that by
his signature on the instrument, the individual , or the person upon behalf of which the individual acted,
executed the instrument.
Signature and Office of Person Taking Acknowledgement
Type/Print Name:
Individual Capacity Outside the State of New York for Real Property
Quitclaim Deed Page 2 of 3
State of ____________ )
) ss.:
County of )
On the day of in the year before me, the undersigned,
personally appeared , personally known to me or proved to
me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within
instrument and acknowledged to me that he executed the same in his capacity , and that by
his signature on the instrument, the individual , or the person upon behalf of which the individual acted,
executed the instrument and that such individual made such appearance before the undersigned in the
(insert the city or other political subdivision and
the State or country or other place the acknowledgment was taken).
Signature and Office of Person Taking Acknowledgement
Type/Print Name:
Names and address of the Grantor: Name and Address of Grantee:
Name:
Address:
City/State/Zip: Name:
Address:
City/State/Zip:
Quitclaim Deed Page 3 of 3
EXHIBIT A
Exhibit A
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