STATE OF NEW YORK )
being duly sworn, depose(s) and say(s):
1. That (I am one of the) (we are the) (grantor[s] grantee[s]) (mortgagor[s]
mortgagee [s]) in (deed) (mortgage) bearing even date herewith (conveying)
(mortgaging) premises known as [Unit/Apt.] [Street Address], [Borough], [City], [State]
2. There are presently - tenants in said premises. Each of said tenants either (a) is in
possession under a lease containing a standard subordination clause fully and
unconditionally subordinating said lease to all existing and future mortgages, or (b) is a
statutory tenant. All persons in possession are in possession pursuant to written leases as
tenants only. There are no options to purchase or rights of first refusal either pursuant to
written leases or by separate agreements.
3. There are (no) street vaults adjoining or in front of said premises.
4. No work has been done upon the above premises by the City of New York nor has
any demand been made by the City of New York for any such work that may result in
charges by the New York City Department of Rent and Housing Maintenance,
Emergency Services or charges by the New York City Department for Environmental
Protection for water tap closings or any related work.
5. No inspection fees, permit fees, elevator(s), sign, boiler or other charges have
been levied, charged, created or incurred that may become tax or other liens pursuant to
Section 26-128 (formerly Section 643a14.0) of the Administrative Code of the City of
New York, as amended by Local Laws 10 of 1981 and 25 of 1984, and Section 27-4029.1
of the Administrative Code of the City of New York as amended by LL 43 (1988) or any
other section of law. I (we) agree to indemnify
(" ") for any loss, cost or damage resulting from any unpaid fee or charge claimed
by the Department of Buildings and entered in the records of the City Collector after the
date of closing.
Sworn to before
me on .
Notary Public State of New York