AFFIDAVIT UNDER SECTION 253(1-a) OF THE TAX LAW

State of ____________ }
County of __________ }ss:

_________________________ being duly sworn, deposes and says:

1. That I am the Mortgagee and a natural person or that we are the Mortgagees and are all natural persons and we all having signed this 253(1-a) Affidavit.

2. The mortgaged premises consist of real property improved by a structure containing six residential dwelling units or less, each with separate cooking facilities.

3. The Mortgagor is ______________________________________ .

4. The amount of this mortgage is ___________________

5. That exemption from further tax is claimed under Section 253(1-a) of the Tax Law as to the said instrument herewith offered for recording.

______________________________
Mortgagee

______________________________
Mortgagee

Sworn to before me this
_____ day of _______, 19___

________________________

Notary Public

Notes:

1. All mortgagees must sign this Affidavit and all must be natural persons. An attorney cannot make this Affidavit on behalf of their client without a Power of Attorney in recordable form and a letter as to why their client cannot sign this Affidavit.

2. Mortgagor does not have to be a natural person.