Section 260 Affidavit (Property Of Two States) Form
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1SECTION 260 AFFIDAVIT
(Property of Two States)
State of ________________}
County of ______________}ss:
___________________________ being duly sworn, says:
I am the ________________ of ___________________________________ , a __________________
(hereinafter called “_______________”), and I am fully familiar with all the facts hereinafter set forth.
1. _________________________ is the Mortgagor under a Mortgage dated this date (the “Mortgage”)
encumbering the property described in Exhibit A, annexed hereto and made a part hereof, and is the
Borrower under the Mortgage dated this date executed and delivered in connection with the Mortgage.
2. A portion of said property described in Exhibit A lies in the Town of ___________________
State of ________________ (outside of New York), and a portion of said property described in Exhibit
A of said property lies in the Town of ________________, State of New York. Annexed hereto marked
Exhibit B and made a part hereof is a surveyor’s metes and bounds description of the property lying in
the State of __________________. Annexed hereto and marked Exhibit C and made a part hereof is a
surveyor’s metes and bounds description of the property lying in the State of New York (hereinafter
called the “Property”). The Property in the State of New York is known as Lot(s) _______________ in
Section _______, Block ______. The assessed valuation of said Property for the ________ (year) Town
Tax and the ___________ (year) School Tax was ________________.
3. Improvements consist of a ____________________________. Substantially all of the improvements
covered by the Mortgage are required to be erected in the State of New York. The only improvements
to be made on the Property outside of the State of New York are : _____________________________.
4. I estimate the cost of the improvements on the New York State Property to be $_________________.
Pursuant to the provisions of Section 260 of the New York State Tax Law, I hereby certify that of the $
______________ principal amount of the Mortgage, the amount of the security for said mortgage which
will be located in the State of New York is $ _____________ representing the cost of the improvements
aforesaid plus the $ ______________ land value, for a total of $ _______________.
5. I further certify that the net value of the property in the State of New York covered by the lien of the
Mortgage will be $ _____________ and that the net value of the property covered by the lien of the
Mortgage located outside of the State of new York will be $ _____________.
______________________________
Sworn to before me this
_____ day of ____________, 20___
_________________________
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