Suffolk County Recording-Endorsement Page Form
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21
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Number of pages
This document will be public
record. Please remove all
Social Security Numbers
prior to recording.
Deed / Mortgage Instrument
Deed / Mortgage Tax Stamp
Recording / Filing Stamps
FEES
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Mortgage Amt.
___________ _____
Page / Filing Fee
___________ ____
1. Basic Tax
___________ _____
20. 00
Handling
___________ ____
2. Additional Tax ___________ _____
Sub Total
___________ _____
TP-584
___________ ____
Spec./Assit.
Notation
___________ ____
or
EA-52 17 (County) ___________ ____
Sub Total ______________
Spec. /Add.
___________ _____
TOT. MTG. TAX ___________ _____
EA-5217 (State)
___________ ____
Dual Town _____ Dual County ____
R.P.T.S.A.
___________ ____
Held for Appointment ________
5. 00
Transfer Tax
___________ _____
Comm. of Ed.
___________ ____
Mansion Tax
___________ _____
Affidavit
___________ ____
The property covered by this mortgage is
Certified Copy
___________ ____
or will be improved by a one or two
family dwelling only.
15. 00
NYS Surcharge
___________ ____
Sub Total _______________
YES ________ or NO ________
Other
___________ ____
If NO, see appropriate tax clause on
Grand Total _______________
page # _______ of this instrument.
Community Preservation Fund
Dist.
Section
Block
Lot
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Real Property
Consideration Amount $ ___________
Tax Service
CPF Tax Due
$ _______________
Agency
Verification
Improved_________
Satisfactions/Discharges/Releases List Property Owners Mailing Address
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Vacant Land ______
RECORD & RETURN TO:
TD _____________
TD _____________
TD _____________
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Title Company Information
Mail to: Judith A. Pascale, Suffolk County Clerk
310 Center Drive, Riverhead, NY 11901
Co. Name
Title #
Suffolk County Recording & Endorsement Page
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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
THRU
MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
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Parent category: Business