Recording and Endorsement Page - Suffolk County
8
Suffolk County Recording & Endorsement Page
This page forms part of the attached ________________________________________________________ made
by:
(SPECIFY TYPE OF INSTRUMENT)
_______________________________________________ The premises herein is situated in
_______________________________________________
SUFFOLK COUNTY, NEW YORK.
TO In the TOWN of ____________________________________
_______________________________________________ In the VILLAGE
_______________________________________________ or HAMLET of _____________________________________
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
Page / Filing Fee ___________ ____
Handling ___________ ____
TP-584 ___________ ____
Notation ___________ ____
EA-52 17 (County) ___________ ____ Sub Total ______________
EA-5217 (State) ___________ ____
R.P.T.S.A. ___________ ____
Comm. of Ed. ___________ ____
Affidavit ___________ ____
Certified Copy ___________ ____
NYS Surcharge ___________ ____
Sub Total _______________
Other ___________ ____
Grand Total _______________
Deed / Mortgage Instrument Deed / Mortgage Tax Stamp Recording / Filing Stamps
3
FEES
(over)
1
Number of pages
This document will be public
record. Please remove all
Social Security Numbers
prior to recording.
2
5. 00
5. 00
Mortgage Amt. ___________ _____
1. Basic Tax ___________ _____
2. Additional Tax ___________ _____
Sub Total
___________ _____
Spec./Assit.
or
Spec. /Add. ___________ _____
TOT. MTG. TAX ___________ _____
Dual Town _____ Dual County ____
Held for Appointment ________
Transfer Tax ___________ _____
Mansion Tax ___________ _____
The property covered by this mortgage is
or will be improved by a one or two
family dwelling only.
YES ________ or NO ________
If NO, see appropriate tax clause on
page # _______ of this instrument.
4
Dist. Section Block Lot
5
Community Preservation Fund
Consideration Amount $ ___________
CPF Tax Due
$ _______________
Real Property
Tax Service
Agency
Verification
Improved_________
Vacant Land ______
TD _____________
TD _____________
TD _____________
7
Title Company Information
Co. Name
Title #
Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD & RETURN TO:
6
15. 00
Mail to: Judith A. Pascale, Suffolk County Clerk
310 Center Drive, Riverhead, NY 11901
www.suffolkcountyny.gov/clerk
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